Active NPI
Stacey Gillis
- Speech-Language Pathologist
- Pearland, TX
National Provider Identifier
1689166159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 113900
- Practice address
- 2011 Broadway St Ste 130
Pearland, TX 77581-5945 - Phone
- (281) 997-8509
- NPI assigned
- May 31, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 113900 | TX | Primary |
Addresses
Primary practice location
2011 Broadway St Ste 130
Pearland, TX 77581-5945
Mailing address
1640 E T C Jester Blvd Apt 916
Houston, TX 77008-2576
Phone (979) 578-2301
Other practice location 1
4100 N Sam Houston Pkwy W
Houston, TX 77086-1465
Phone (713) 383-9700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 113900 | TX | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| TCG Home Health LLC | Past | Accepting new patients | |
| Riverkids Houston Therapy, LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Home Health Agency
- Pearland, TX
- NPI 1780729731
-
- Rehabilitation Clinic/Center
- Houston, TX
- NPI 1902228604
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573689600000",
"number": "1689166159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1640 E T C JESTER BLVD APT 916",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770082576",
"telephone_number": "979-578-2301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2011 BROADWAY ST STE 130",
"city": "PEARLAND",
"state": "TX",
"postal_code": "775815945",
"telephone_number": "281-997-8509"
}
],
"practiceLocations": [
{
"address_1": "4100 N Sam Houston Pkwy W",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770861465",
"country_code": "US",
"telephone_number": "713-383-9700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GILLIS",
"first_name": "STACEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-31",
"last_updated": "2019-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "113900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pearland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.