Individual provider Active NPI

Meredith Jurica

  • Speech-Language Pathologist
  • Willis, TX
National Provider Identifier
1760936108
Registry record updated Aug 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
185561 Issued in TX
Practice address
12625 Maggie LN
Willis, TX 77318-7514
Phone
(361) 813-2728
NPI assigned
Aug 14, 2016
Last updated
Aug 14, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 185561 TX Primary

Addresses

Primary practice location

12625 Maggie LN
Willis, TX 77318-7514

Mailing address

12625 Maggie LN
Willis, TX 77318-7514
Phone (361) 813-2728

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

LicenseStateTypeSpecialty
185561TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1471132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471132800000",
    "number": "1760936108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12625 MAGGIE LN",
            "city": "WILLIS",
            "state": "TX",
            "postal_code": "773187514",
            "telephone_number": "361-813-2728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12625 MAGGIE LN",
            "city": "WILLIS",
            "state": "TX",
            "postal_code": "773187514",
            "telephone_number": "361-813-2728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURICA",
        "first_name": "MEREDITH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-14",
        "last_updated": "2016-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "185561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willis, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2016; 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.