Staci L Carlson

Individual provider Active NPI Speech-Language Pathologist · El Paso, TX

NPI 1679607667 · NPPES record last updated Nov 30, 2015

Key facts

NPI
1679607667
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
17696 (TX)
Practice address
6800 Gateway Blvd E
BLDG 4a
El Paso, TX 79915-1040
Phone
(915) 779-7827
NPI assigned
Mar 14, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 3

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
17696TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
TS Carlson Pediatric Rehab LP Current Accepting new patients
Ability - All 4 Kids, LLC Current Accepting new patients
Healthstar Family Rehab Center, LLC Current Accepting new patients

Locations

6800 Gateway Blvd E
Ste 4A
El Paso, TX 79915
Phone (915) 779-7827

7840 FM 1960 Rd E
Ste 401
Humble, TX 77346
Phone (281) 548-2458

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 17696 TX Yes

Addresses

Primary practice location

6800 Gateway Blvd E
BLDG 4a
El Paso, TX 79915-1040

Mailing address

6800 Gateway Blvd E
BLDG 4a
El Paso, TX 79915-1040
Phone (915) 779-7827

Other providers in El Paso, TX

All providers in El Paso, TX · Speech-Language Pathologist in Texas

Sources for this page

Verify at the official NPI Registry.