Active NPI
Pamela Tatum
- Speech-Language Pathologist
- San Antonio, TX
National Provider Identifier
1760657456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 14384
- Practice address
- 6655 First Park Ten Blvd
San Antonio, TX 78213-4308 - Phone
- (210) 733-0524
- NPI assigned
- Apr 24, 2008
- 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 | 14384 | TX | Primary |
Addresses
Primary practice location
6655 First Park Ten Blvd
San Antonio, TX 78213-4308
Mailing address
8546 Pendragon St
San Antonio, TX 78254-2052
Phone (210) 823-1939
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 |
|---|---|---|---|
| 14384 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208995200000",
"number": "1760657456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8546 PENDRAGON ST",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782542052",
"telephone_number": "210-823-1939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6655 FIRST PARK TEN BLVD",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782134308",
"telephone_number": "210-733-0524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TATUM",
"first_name": "PAMELA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-24",
"last_updated": "2008-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "14384",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.