Individual provider Active NPI

Maricarmen De la Cruz, MS CCC SLP

  • Speech-Language Pathologist
  • Flower Mound, TX
National Provider Identifier
1396972691
Registry record updated Jan 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
109917 Issued in TX
Practice address
4101 Sharondale Dr
Flower Mound, TX 75022-0957
Phone
(817) 908-4909
NPI assigned
Jun 15, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 545 PR
Speech-Language Pathologist 235Z00000X 109917 TX Primary

Addresses

Primary practice location

4101 Sharondale Dr
Flower Mound, TX 75022-0957

Mailing address

4101 Sharondale Dr
Flower Mound, TX 75022-0957
Phone (817) 908-4909

Other practice location 1

3840 Hulen St Ste 100
Fort Worth, TX 76107-7269
Phone (817) 569-4300

Other identifiers 4

IdentifierTypeStateIssuer
8ES496OtherTXBLUE CROSS BLUE SHIELD
109917OtherTXSTATE BOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY
337738401MedicaidTX
545OtherPRPROFESSIONAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
109917TXMDPediatric Occupational Therapist
545PRMDAssistive Technology Practitioner Audiologist

Practice roles

OrganizationSpecialtyStatusNew patients
My Health My Resources of Tarrant County Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769731200000",
    "number": "1396972691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 SHARONDALE DR",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750220957",
            "telephone_number": "817-908-4909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 SHARONDALE DR",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750220957",
            "telephone_number": "817-908-4909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3840 Hulen St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761077269",
            "country_code": "US",
            "telephone_number": "817-569-4300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LA CRUZ",
        "first_name": "MARICARMEN",
        "name_prefix": "Mrs.",
        "credential": "MS CCC SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-15",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PR",
            "license": "545",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "109917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8ES496",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY",
            "identifier": "109917",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "337738401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "545",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flower Mound, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.