Organization Active NPI

Speech Language and Auditory Learning

  • Speech-Language Pathologist
  • Tyler, TX
National Provider Identifier
1609080613
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
11594 Issued in TX
Legal business name
SPEECH LANGUAGE AND AUDITORY LEARNING
Practice address
5528 Old Bullard Rd
Suite 103
Tyler, TX 75703-4362
Phone
(903) 581-5421
Fax
(903) 581-4515
NPI assigned
May 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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

Authorized official

Name
Mrs. Suzanne Herman, M. ED., CCC-SLP
Title
Speech Pathologist
Phone
(903) 581-5421

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 11594 TX Primary

Addresses

Primary practice location

5528 Old Bullard Rd
Suite 103
Tyler, TX 75703-4362

Mailing address

5528 Old Bullard Rd
Suite 103
Tyler, TX 75703-4362
Phone (903) 581-5421

Other identifiers 2

IdentifierTypeStateIssuer
005616001MedicaidTX
0072ELOtherTXBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

5528 Old Bullard Rd
Ste 103
Tyler, TX 75703
Phone (903) 581-5421

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1609080613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5528 OLD BULLARD RD",
            "address_2": "SUITE 103",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757034362",
            "telephone_number": "903-581-5421",
            "fax_number": "903-581-4515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5528 OLD BULLARD RD",
            "address_2": "SUITE 103",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757034362",
            "telephone_number": "903-581-5421",
            "fax_number": "903-581-4515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEECH LANGUAGE AND AUDITORY LEARNING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "HERMAN",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "SPEECH PATHOLOGIST",
        "authorized_official_telephone_number": "903-581-5421",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M. ED., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "11594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005616001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0072EL",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; 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.