Active NPI
Diana Vaccaro, SLP
- Speech-Language Pathologist
- Katy, TX
National Provider Identifier
1508019589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 104913
- Practice address
- 20615 Fawnbrook CT
Katy, TX 77450-8548 - Phone
- (646) 645-2001
- Fax
- (281) 829-7897
- NPI assigned
- Nov 4, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 014088-1 | NY | |
| Speech-Language Pathologist | 235Z00000X | 104913 | TX | Primary |
Addresses
Primary practice location
20615 Fawnbrook CT
Katy, TX 77450-8548
Mailing address
20615 Fawnbrook CT
Katy, TX 77450-8548
Phone (646) 645-2001
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
| License | State | Type | Specialty |
|---|---|---|---|
| 014088-1 | NY | MD | Psychologist |
| 104913 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350000000000",
"number": "1508019589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20615 FAWNBROOK CT",
"city": "KATY",
"state": "TX",
"postal_code": "774508548",
"telephone_number": "646-645-2001",
"fax_number": "281-829-7897"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20615 FAWNBROOK CT",
"city": "KATY",
"state": "TX",
"postal_code": "774508548",
"telephone_number": "646-645-2001",
"fax_number": "281-829-7897"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VACCARO",
"first_name": "DIANA",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-11-04",
"last_updated": "2012-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "014088-1",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "104913",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Katy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.