Individual provider Active NPI

Amy Lynn Martinez Watson

  • Speech-Language Pathologist
  • Austin, TX
National Provider Identifier
1578061123
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
104627 Issued in TX
Practice address
8505 Cross Park Dr Ste 120
Austin, TX 78754-4552
Phone
(361) 658-4799
NPI assigned
Jan 30, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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 104627 TX Primary

Addresses

Primary practice location

8505 Cross Park Dr Ste 120
Austin, TX 78754-4552

Mailing address

52 Country Oaks Dr
Buda, TX 78610-9338
Phone (361) 658-4799

Other practice location 1

540 Staples Rd
San Marcos, TX 78666-1406
Phone (512) 393-6754

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
104627TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1517270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1578061123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 COUNTRY OAKS DR",
            "city": "BUDA",
            "state": "TX",
            "postal_code": "786109338",
            "telephone_number": "361-658-4799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8505 CROSS PARK DR STE 120",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787544552",
            "telephone_number": "361-658-4799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "540 Staples Rd",
            "address_purpose": "LOCATION",
            "city": "San Marcos",
            "state": "TX",
            "postal_code": "786661406",
            "country_code": "US",
            "telephone_number": "512-393-6754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "AMY",
        "middle_name": "LYNN MARTINEZ",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-30",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "104627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.