Active NPI
Mystere Moyes
- Speech-Language Pathologist
- Garland, TX
National Provider Identifier
1508428384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 110674
- Practice address
- 930 W Centerville Rd Ste C
Garland, TX 75041-5854 - Phone
- (972) 303-7021
- NPI assigned
- Jul 2, 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 | 110674 | TX | Primary |
Addresses
Primary practice location
930 W Centerville Rd Ste C
Garland, TX 75041-5854
Mailing address
3532 Cripple Creek Dr
Dallas, TX 75224-3718
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | Epic |
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 |
|---|---|---|---|
| 110674 | TX | MD | Hand Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562025600000",
"number": "1508428384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3532 CRIPPLE CREEK DR",
"city": "DALLAS",
"state": "TX",
"postal_code": "752243718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "930 W CENTERVILLE RD STE C",
"city": "GARLAND",
"state": "TX",
"postal_code": "750415854",
"telephone_number": "972-303-7021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOYES",
"first_name": "MYSTERE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-02",
"last_updated": "2019-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "110674",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "Epic",
"affiliation": "N",
"address_1": "930 W Centerville Rd Ste C",
"city": "Garland",
"state": "TX",
"country_code": "US",
"postal_code": "750415854",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Garland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.