Moon Lily Therapy PPLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

105616 Issued in TX

Legal business name

MOON LILY THERAPY PPLC

Practice address

2110 Shearn St Unit F41
Houston, TX 77007-3972

Phone

(713) 562-2572

Fax

(713) 932-6713

NPI assigned

Jun 6, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Angela Sue Owens, SLP

Title

Speech/Language Pathologist

Phone

(713) 562-2572

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1689103319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 SHEARN ST UNIT F412110",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770073962",
            "telephone_number": "713-562-2572",
            "fax_number": "713-932-6713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 SHEARN ST UNIT F41",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770073972",
            "telephone_number": "713-562-2572",
            "fax_number": "713-932-6713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOON LILY THERAPY PPLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-06",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "OWENS",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "SPEECH/LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "713-562-2572",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "105616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "528750",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Moody
• Shade' Bethena Moody, MD
• Lisa Mook, R.D.L.D.
• Yasmin Moolani, M.D.
• James Moomaw, LMFT
• Moon Wellness Space
• Alex Moon, PTA
• Amber Jisoo Moon
• Brittany Guajardo Moon, AU.D
• Caitlin Moon

• Speech-Language Pathologist in Houston, TX
• Providers in Houston, 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 21, 2022; 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.