Individual provider Active NPI

Fajhr Qureshi, CCC-SLP

  • Speech-Language Pathologist
  • Irving, TX
National Provider Identifier
1508554247
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
117611 Issued in TX
Practice address
100 Decker CT Ste 191
Irving, TX 75062-2205
Phone
(214) 295-5374
NPI assigned
May 1, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2023

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 117611 TX Primary

Addresses

Primary practice location

100 Decker CT Ste 191
Irving, TX 75062-2205

Mailing address

3800 Pebble Creek CT Apt 719
Plano, TX 75023-5951
Phone (480) 678-5852

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
117611TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mentis Management Services, LLC CurrentSince Mar 24, 2024 Accepting new patients
Mentis Management Services, LLC PastSince May 7, 2023 Accepting new patients

Locations

100 Decker Ct
Ste 191
Irving, TX 75062
Phone (214) 295-5374

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1682899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1508554247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 PEBBLE CREEK CT APT 719",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750235951",
            "telephone_number": "480-678-5852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 DECKER CT STE 191",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750622205",
            "telephone_number": "214-295-5374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QURESHI",
        "first_name": "FAJHR",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-01",
        "last_updated": "2023-05-01",
        "certification_date": "2023-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "117611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; 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.