Active NPI
Traci Daigle
- Speech-Language Pathologist
- Lubbock, TX
National Provider Identifier
1578933529
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 101392
- Practice address
- 6520 43Rd St
Lubbock, TX 79407-1941 - Phone
- (866) 368-6565
- NPI assigned
- Oct 3, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 | 101392 | TX | Primary |
Addresses
Primary practice location
6520 43Rd St
Lubbock, TX 79407-1941
Mailing address
9108 Ridgely Ave
Lubbock, TX 79424-7553
Phone (817) 455-4779
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 |
|---|---|---|---|
| 101392 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443830400000",
"number": "1578933529",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9108 RIDGELY AVE",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794247553",
"telephone_number": "817-455-4779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6520 43RD ST",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794071941",
"telephone_number": "866-368-6565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAIGLE",
"first_name": "TRACI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-03",
"last_updated": "2015-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "101392",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.