NPIMap

Organization Active NPI

Tanya Manriquez Lujan M.S., CCC-SLP, PLLC

  • Speech-Language Pathologist
  • Odessa, TX
National Provider Identifier
1669836573
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
TANYA MANRIQUEZ LUJAN M.S., CCC-SLP, PLLC
Practice address
4010 Medical Park Dr
Odessa, TX 79765-2233
Phone
(432) 614-0268
Fax
(888) 972-6512
NPI assigned
Apr 6, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Authorized official

Name
Tanya Manriquez Lujan, M.S., CCC-SLP, COMNPI 1457740110
Title
Speech Language Pathologist
Phone
(432) 661-5405

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 2355S0801X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

4010 Medical Park Dr
Odessa, TX 79765-2233

Mailing address

3311 Milano Dr
Odessa, TX 79765-8979
Phone (432) 661-5405

Other names 1

  • West Texas Speech Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160610000273 TX Part B Supplier - Clinic/Group Practice 6800186487 Receives reassigned benefits from 5 practitioners
Practice locations: Odessa, TX

National Provider Directory

National Provider Directory

Locations

4010 Medical Park Dr
Odessa, TX 79765
Phone (432) 614-0268

Practitioners & affiliated clinicians

Practitioners 5

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": "1459900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697500800000",
    "number": "1669836573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3311 MILANO DR",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797658979",
            "telephone_number": "432-661-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 MEDICAL PARK DR",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797652233",
            "telephone_number": "432-614-0268",
            "fax_number": "888-972-6512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANYA MANRIQUEZ LUJAN M.S., CCC-SLP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-06",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A",
        "authorized_official_last_name": "LUJAN",
        "authorized_official_first_name": "TANYA",
        "authorized_official_middle_name": "MANRIQUEZ",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "432-661-5405",
        "authorized_official_credential": "M.S., CCC-SLP, COM"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Texas Speech Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "West Texas Speech Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Odessa, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.