Active NPI
Karona Michelle Bullock, CCC-SLP
- Speech-Language Pathologist
- Houston, TX
National Provider Identifier
1740660406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 105315
- Practice address
- 6109 Maple St
Houston, TX 77074-7449 - Phone
- (713) 688-6690
- NPI assigned
- Jun 8, 2015
- Last updated
- Jun 8, 2015
- 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 | 105315 | TX | Primary |
Addresses
Primary practice location
6109 Maple St
Houston, TX 77074-7449
Mailing address
14723 W Oak Plaza Street
Apt 535
Houston, TX 77082
Phone (225) 776-1647
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 |
|---|---|---|---|
| 105315 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| KDT, LLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433721600000",
"number": "1740660406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14723 W OAK PLAZA STREET",
"address_2": "APT 535",
"city": "HOUSTON",
"state": "TX",
"postal_code": "77082",
"telephone_number": "225-776-1647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6109 MAPLE ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770747449",
"telephone_number": "713-688-6690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BULLOCK",
"first_name": "KARONA",
"middle_name": "MICHELLE",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-08",
"last_updated": "2015-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "105315",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.