Active NPI
Leslie Marie Lok
- Speech-Language Pathologist
- Fort Worth, TX
National Provider Identifier
1689312191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 111739
- Practice address
- 3604 Cimmaron TRL
Fort Worth, TX 76116-6851 - Phone
- (817) 815-6700
- NPI assigned
- May 24, 2022
- 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 | 111739 | TX | Primary |
Addresses
Primary practice location
3604 Cimmaron TRL
Fort Worth, TX 76116-6851
Mailing address
3604 Cimmaron TRL
Fort Worth, TX 76116-6851
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467509224 | Medicaid | TX |
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 |
|---|---|---|---|
| 111739 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653350400000",
"number": "1689312191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3604 CIMMARON TRL",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761166851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3604 CIMMARON TRL",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761166851",
"telephone_number": "817-815-6700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOK",
"first_name": "LESLIE",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-24",
"last_updated": "2022-05-24",
"certification_date": "2022-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "111739",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1467509224",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.