Trailblazer Speech Therapy PLLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

TRAILBLAZER SPEECH THERAPY PLLC

Practice address

136 W Purnell Rd
Lewisville, TX 75057-3918

Phone

(469) 713-5203

NPI assigned

Jul 26, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Melinda Rogers, CCC-SLP

Title

Owner/President

Phone

(972) 839-1833

Specialties & licenses 1

Addresses

Other names 1

• Trailblazer Speech Therapy PLLC Doing business as

Locations

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

{
    "created_epoch": "1564099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564099200000",
    "number": "1538713631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8001 CENTERVIEW PKWY",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380184228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 W PURNELL RD",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750573918",
            "telephone_number": "469-713-5203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAILBLAZER SPEECH THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-26",
        "last_updated": "2019-07-26",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "972-839-1833",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trailblazer Speech Therapy PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Speech-Language Pathologist in Lewisville, TX
• Providers in Lewisville, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.

Verify at the official NPI Registry.