Individual provider Active NPI

Amy Imbaquingo

  • Speech-Language Pathologist
  • Houston, TX
National Provider Identifier
1437902012
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
122183 Issued in TX
Practice address
1110 Enclave Pkwy
Houston, TX 77077-1606
Phone
(832) 593-6767
Fax
(281) 741-3521
NPI assigned
Apr 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 122183 TX Primary

Addresses

Primary practice location

1110 Enclave Pkwy
Houston, TX 77077-1606

Mailing address

13611 Skinner Rd Ste 250
Cypress, TX 77429-4692
Phone (832) 593-6767

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

State licenses

LicenseStateTypeSpecialty
122183TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Speech Emporium Inc Speech-Language Pathologist CurrentSince Apr 14, 2024 Accepting new patients

Locations

13611 Skinner Rd
Ste 250
Cypress, TX 77429
Phone (832) 593-6767

1110 Enclave Pkwy
Houston, TX 77077
Phone (281) 741-3372

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": "1712793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1437902012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13611 SKINNER RD STE 250",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774294692",
            "telephone_number": "832-593-6767",
            "fax_number": "832-593-6868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 ENCLAVE PKWY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770771606",
            "telephone_number": "832-593-6767",
            "fax_number": "281-741-3521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMBAQUINGO",
        "first_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-11",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "122183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.