Eddwado Perkin, M.S.CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

462354190 Issued in TX

Practice address

1308 Matthew Dr
Mesquite, TX 75149-7700

Phone

(773) 640-8340

NPI assigned

Apr 1, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Star Light Speech Therapy Services

  • Speech-Language Pathologist
  • Mesquite, TX
  • NPI 1922341213
  NPD (past) Authorized official

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

{
    "created_epoch": "1364774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1649513383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 MATTHEW DR",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751497700",
            "telephone_number": "773-640-8340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 MATTHEW DR",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751497700",
            "telephone_number": "773-640-8340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERKIN",
        "first_name": "EDDWADO",
        "credential": "M.S.CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-01",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "105956",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "462354190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juan Carlos Pena, DC
• Daniel Lee Pennell, D.C.
• Aaron Penny
• Roselio Perez Garcia, FNP
• Briana Tresa Janee Perez, A.S, B.A, B.S
• Athena Perry-Le
• Brian Perry Sr., LPC
• Katina Perry, MSW
• Personal Care Products, Inc.
• Rebekah Peters

• Speech-Language Pathologist in Mesquite, TX
• Providers in Mesquite, 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 May 23, 2023; 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.