Melissa Ann Boltz, ST

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

111577 Issued in TX

Practice address

2011 Broadway St Ste 130
Pearland, TX 77581-5945

Phone

(312) 943-3600

NPI assigned

Mar 16, 2007

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1598899759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3311 STONEHURST CT",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775845939",
            "telephone_number": "773-304-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 BROADWAY ST STE 130",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775815945",
            "telephone_number": "312-943-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTZ",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "credential": "ST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146008101",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "111577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103034",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jemma Louise Bohlar-Marshman, OTR/L
• Karen D Bolton, FNP
• Gina Marie Bonaventura, DDS, MS
• Rizalina Marcial Bonuel, RN
• Shelby Booth
• Bootin and Savrick Pediatric Associates
• David Ned Booy, MD

• Speech-Language Pathologist in Pearland, TX
• Providers in Pearland, 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 21, 2022; 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.