Individual provider Active NPI

Alicia Thompson Wanek, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Plano, TX
National Provider Identifier
1609091263
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
18869 Issued in TX
Practice address
2036 Antwerp Ave
Plano, TX 75025-3321
Phone
(214) 789-4775
NPI assigned
Apr 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 18869 TX Primary

Addresses

Primary practice location

2036 Antwerp Ave
Plano, TX 75025-3321

Mailing address

2036 Antwerp Ave
Plano, TX 75025-3321
Phone (214) 789-4775

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
18869TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609091263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2036 ANTWERP AVE",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750253321",
            "telephone_number": "214-789-4775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2036 ANTWERP AVE",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750253321",
            "telephone_number": "214-789-4775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANEK",
        "first_name": "ALICIA",
        "middle_name": "THOMPSON",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "18869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.