Taylor Kiana Wallace, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

101 Uhland Rd
San Marcos, TX 78666-6630

Phone

(512) 396-0872

NPI assigned

Oct 30, 2017

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

Medicare fee-for-service enrollment

Enrolled in TX, MD, PA3 enrollments

Enrollment records 3

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

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.

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• Expressable Therapy PC

  • Speech-Language Pathologist
  • Austin, TX
  • NPI 1134875370

  MD, PA

  Medicare reassignment NPD

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

{
    "created_epoch": "1509321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509321600000",
    "number": "1689186728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2862 ALDEBARAN WAY W",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366934200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 UHLAND RD",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786666630",
            "telephone_number": "512-396-0872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "TAYLOR",
        "middle_name": "KIANA",
        "name_prefix": "Miss",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-30",
        "last_updated": "2017-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores Texas LLC
• Wal-Mart Stores Texas, LP
• Walgreen Co
• Walgreen Co
• Shawn Jeffrey Walker Jr., MD
• Jack Wesley Wallis, MD
• Mary M Wally, SLP
• Kathryn Nicole Walpole
• Andrew Lee Walsh III, MD
• Derrick Wansom, MD

• Speech-Language Pathologist in San Marcos, TX
• Providers in San Marcos, 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 Oct 30, 2017; 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.