Teresa Medina
Individual provider Active NPI Speech-Language Pathologist · Sunland Park, NM
NPI 1629280425 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1629280425
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 3115 (NM)
- Practice address
- 4950 MC Nutt Rd
Sunland Park, NM 88063 - Phone
- (505) 882-6200
- NPI assigned
- May 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3115 | NM | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gadsden Independent School District | Past | Accepting new patients | |
| Gadsden Independent School District | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 3115 | NM | Yes |
Addresses
Primary practice location
4950 MC Nutt Rd
Sunland Park, NM 88063
Mailing address
P.O. Drawer 70
Anthony, NM 88021
Other providers in Sunland Park, NM
- Ronald Martinez
- Matthew Mattox
- Breeana Maya-Villegas
- Med-Care P.a. LLC
- Med-Care P.a., LLC.
- Sucharitha Meka
- Nora L Mendoza de Candelaria
- Andrea Yaneli Mendoza
- Santana Mendoza
- Joy Midkiff-Calvert
All providers in Sunland Park, NM · Speech-Language Pathologist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.