Tracy Edenson Borejdo, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

105605 Issued in TX

Practice address

12225 Greenville Ave # 600
Dallas, TX 75243-9362

Phone

(866) 575-9820

NPI assigned

Apr 12, 2019

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555027200000",
    "number": "1700349081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 MCKINNEY AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752054526",
            "telephone_number": "972-749-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12225 GREENVILLE AVE # 600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752439362",
            "telephone_number": "866-575-9820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4200 McKinney Ave # 2",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752054526",
            "country_code": "US",
            "telephone_number": "972-749-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOREJDO",
        "first_name": "TRACY",
        "middle_name": "EDENSON",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-12",
        "last_updated": "2019-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "105605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooklyn Lorene Bordano, MSN, AGACNP-BC
• Rebecca Bordelon, DC
• Micheal J Borden, PA-C
• Kimberly Bordwine, CAA
• Muriel K Boreham, MD
• Ariel Paige Borel, DPT
• Bryant Carroll Boren III, MD
• Claire Boren
• Melissa Boren
• Monica Lynn Boren, NNP

• Speech-Language Pathologist in Dallas, TX
• Providers in Dallas, 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 Apr 12, 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.

Verify at the official NPI Registry.