Individual provider Active NPI

Ahmad Mike Hassan, SLP - A

  • Speech-Language Pathologist
  • Rockwall, TX
National Provider Identifier
1548890619
Registry record updated Jan 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
40526 Issued in TX
Practice address
789 Justin Road
Rockwall, TX 75087-4840
Phone
(972) 771-5731
Fax
(972) 771-5786
NPI assigned
Jan 17, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2020

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 40526 TX Primary

Addresses

Primary practice location

789 Justin Road
Rockwall, TX 75087-4840

Mailing address

789 Justin Road
Rockwall, TX 75087-4840
Phone (972) 771-5731

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
40526TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1579219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579219200000",
    "number": "1548890619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "789 JUSTIN ROAD",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750874840",
            "telephone_number": "972-771-5731",
            "fax_number": "972-771-5786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 JUSTIN ROAD",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750874840",
            "telephone_number": "972-771-5731",
            "fax_number": "972-771-5786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "AHMAD",
        "middle_name": "MIKE",
        "name_prefix": "Mr.",
        "credential": "SLP - A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-17",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "40526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockwall, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; 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.