Individual provider Active NPI

Rose Marie Wagman, M.A.

  • Speech-Language Pathologist
  • Houston, TX
National Provider Identifier
1780969766
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
12299 Issued in TX
Practice address
1419 Lakecliff Dr
Houston, TX 77077-3015
Phone
(281) 497-7254
NPI assigned
Oct 20, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

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 12299 TX Primary

Addresses

Primary practice location

1419 Lakecliff Dr
Houston, TX 77077-3015

Mailing address

1419 Lakecliff Dr
Houston, TX 77077-3015
Phone (281) 497-7254

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
12299TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1780969766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1419 LAKECLIFF DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770773015",
            "telephone_number": "281-497-7254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1419 LAKECLIFF DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770773015",
            "telephone_number": "281-497-7254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGMAN",
        "first_name": "ROSE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-20",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "12299",
            "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 Oct 20, 2011; 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.