Active NPI
Magdalene C Gonzales, SLP
- Speech-Language Pathologist
- Fort Worth, TX
National Provider Identifier
1457912693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 114663
- Practice address
- 923 Pennsylvania Ave Ste 100
Fort Worth, TX 76104-2254 - Phone
- (817) 920-0484
- Fax
- (817) 920-0068
- NPI assigned
- Jun 27, 2019
- Last updated
- Jun 27, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 114663 | TX | Primary |
Addresses
Primary practice location
923 Pennsylvania Ave Ste 100
Fort Worth, TX 76104-2254
Mailing address
P.O. Box 961205
Fort Worth, TX 76161-1205
Phone (817) 740-8400
Other practice location 1
4300 N Central Expy Ste 110
Dallas, TX 75206-6533
Phone (214) 823-3333
Other practice location 2
900 W Magnolia Ave Ste 200
Fort Worth, TX 76104-4678
Phone (817) 882-1193
Other practice location 3
75 Main St Ste 150
Colleyville, TX 76034-2970
Phone (817) 503-2442
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561593600000",
"number": "1457912693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 961205",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761611205",
"telephone_number": "817-740-8400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "923 PENNSYLVANIA AVE STE 100",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761042254",
"telephone_number": "817-920-0484",
"fax_number": "817-920-0068"
}
],
"practiceLocations": [
{
"address_1": "4300 N Central Expy Ste 110",
"address_purpose": "LOCATION",
"city": "Dallas",
"state": "TX",
"postal_code": "752066533",
"country_code": "US",
"telephone_number": "214-823-3333",
"fax_number": "214-823-3355",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "900 W Magnolia Ave Ste 200",
"address_purpose": "LOCATION",
"city": "Fort Worth",
"state": "TX",
"postal_code": "761044678",
"country_code": "US",
"telephone_number": "817-882-1193",
"fax_number": "817-870-1602",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "75 Main St Ste 150",
"address_purpose": "LOCATION",
"city": "Colleyville",
"state": "TX",
"postal_code": "760342970",
"country_code": "US",
"telephone_number": "817-503-2442",
"fax_number": "817-968-2443",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GONZALES",
"first_name": "MAGDALENE",
"middle_name": "C",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-27",
"last_updated": "2019-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "114663",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.