Individual provider Active NPI

Vanessa Cavazos, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Weslaco, TX
National Provider Identifier
1457925174
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
113607 Issued in TX
Practice address
2115 W Pike Blvd
Weslaco, TX 78596-0054
Phone
(956) 377-8000
NPI assigned
May 17, 2021
Last updated
Aug 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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 113607 TX Primary

Addresses

Primary practice location

2115 W Pike Blvd
Weslaco, TX 78596-0054

Mailing address

1305 W Heritage Dr Apt 4
Pharr, TX 78577-2855
Phone (956) 975-5903

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
113607TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Idea Florida, Inc. CurrentSince Jun 25, 2023 Accepting new patients
Renaissance Outpatient Rehabilitation Center, LLC Past Accepting new patients

Locations

2115 W Pike Blvd
Weslaco, TX 78596
Phone (956) 377-8000

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1457925174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 W HERITAGE DR APT 4",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "785772855",
            "telephone_number": "956-975-5903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 W PIKE BLVD",
            "city": "WESLACO",
            "state": "TX",
            "postal_code": "785960054",
            "telephone_number": "956-377-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVAZOS",
        "first_name": "VANESSA",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-17",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "113607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weslaco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.