Active NPI
Mia Rusdal
- Speech-Language Pathologist
- Round Rock, TX
National Provider Identifier
1700664836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 121383
- Practice address
- 1201 N Interstate Hwy 35
Ste 105
Round Rock, TX 78664 - Phone
- (817) 205-2889
- NPI assigned
- Sep 19, 2023
- 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 | 121383 | TX | Primary |
Addresses
Primary practice location
1201 N Interstate Hwy 35
Ste 105
Round Rock, TX 78664
Mailing address
8537 Steeple Ridge Dr
North Richland Hills, TX 76182-8325
Phone (817) 205-2889
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 |
|---|---|---|---|
| 121383 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Easter Seals Central Texas Inc | Speech-Language Pathologist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Early Intervention Provider Agency
- Austin, TX
- NPI 1013991017
Speech-Language Pathologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725494400000",
"number": "1700664836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8537 STEEPLE RIDGE DR",
"city": "NORTH RICHLAND HILLS",
"state": "TX",
"postal_code": "761828325",
"telephone_number": "817-205-2889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 N INTERSTATE HWY 35",
"address_2": "STE 105",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "78664",
"telephone_number": "817-205-2889"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSDAL",
"first_name": "MIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-19",
"last_updated": "2024-09-05",
"certification_date": "2024-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "121383",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Round Rock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.