Active NPI
Roberta Lima Guditis
- Speech-Language Pathologist
- Lake Dallas, TX
National Provider Identifier
1558976571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 117211
- Practice address
- 401 Main St
Lake Dallas, TX 75065-2725 - Phone
- (940) 497-2222
- NPI assigned
- Sep 15, 2020
- 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 | 117211 | TX | Primary |
Addresses
Primary practice location
401 Main St
Lake Dallas, TX 75065-2725
Mailing address
104 Swisher Rd
Lake Dallas, TX 75065-2322
Phone (940) 497-4039
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 |
|---|---|---|---|
| 117211 | TX | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Dallas Isd | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Local Education Agency (LEA)
- Lake Dallas, TX
- NPI 1699044032
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724976000000",
"number": "1558976571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 SWISHER RD",
"city": "LAKE DALLAS",
"state": "TX",
"postal_code": "750652322",
"telephone_number": "940-497-4039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 MAIN ST",
"city": "LAKE DALLAS",
"state": "TX",
"postal_code": "750652725",
"telephone_number": "940-497-2222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUDITIS",
"first_name": "ROBERTA",
"middle_name": "LIMA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-15",
"last_updated": "2024-08-30",
"certification_date": "2024-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "117211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.