Mary Ruth Fernandez, MA CCCSLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

12916 Issued in TX

Practice address

411 SW 24TH Street
Harry Jersig Center Our Lady of the Lake University
San Antonio, TX 78207-4689

Phone

(210) 434-6711

Fax

(210) 434-9360

NPI assigned

Apr 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• Our Lady of the Lake University

  • Speech-Language Pathologist
  • San Antonio, TX
  • NPI 1063622314
  NPD (past)
• Our Lady of the Lake University San Antonio

  • Audiologist
  • San Antonio, TX
  • NPI 1952020687

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669698692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 SW 24TH STREET",
            "address_2": "HARRY JERSIG CENTER OUR LADY OF THE LAKE UNIVERSITY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782074689",
            "telephone_number": "210-434-6711",
            "fax_number": "210-434-9360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 SW 24TH STREET",
            "address_2": "HARRY JERSIG CENTER OUR LADY OF THE LAKE UNIVERSITY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782074689",
            "telephone_number": "210-434-6711",
            "fax_number": "210-434-9360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "MARY",
        "middle_name": "RUTH",
        "name_prefix": "Ms.",
        "credential": "MA CCCSLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "12916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003747501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX",
            "identifier": "87863T",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lexey Noelle Fernandez
• Liliana Garcia Fernandez
• Margaret H Fernandez, NP
• Margarita Fernandez, LPN
• Mario Benjamin Fernandez, M.D.
• Miguel Fernandez, MD
• Naomi Fernandez, SPEECH ASSISTANT,BS
• Norma Elena Fernandez, SLP-ASSISTANT
• Sandra G Fernandez, MD
• Sergio Fernandez, LPC

• Speech-Language Pathologist in San Antonio, TX
• Providers in San Antonio, 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 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.