Individual provider Active NPI

Bre'Anna Valenzuela, M.S., CCC-SLP

  • Speech-Language Pathologist
  • North Richland Hills, TX
National Provider Identifier
1790487676
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
111924 Issued in TX
Practice address
7801 N Richland Blvd
North Richland Hills, TX 76180-6415
Phone
(469) 307-4561
NPI assigned
Mar 21, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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 111924 TX Primary

Addresses

Primary practice location

7801 N Richland Blvd
North Richland Hills, TX 76180-6415

Mailing address

6529 Wooddale Dr
Watauga, TX 76148-2854
Phone (469) 307-4561

Other practice location 1

6350 Winter Park Dr
North Richland Hills, TX 76180-5363
Phone (469) 307-4561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230421002618 TX Practitioner - Qualified Speech Language Pathologist 4486019692 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Powerback Rehabilitation LLCGroup PAC ID 2365359932, 600 clinicians

Practice addresses (Care Compare)

7801 N Richland Blvd
North Richland Hills, TX 76180-6415
Phone (469) 609-9044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
111924TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Powerback Rehabilitation LLC Speech-Language Pathologist CurrentSince Mar 1, 2023 Accepting new patients
Powerback Rehabilitation LLC Speech-Language Pathologist CurrentSince Mar 1, 2023 Accepting new patients

Locations

7801 N Richland Blvd
North Richlnd Hls, TX 76180
Phone (469) 609-9044

6350 Winter Park Dr
Richland Hills, TX 76180
Phone (817) 380-4956

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1790487676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6529 WOODDALE DR",
            "city": "WATAUGA",
            "state": "TX",
            "postal_code": "761482854",
            "telephone_number": "469-307-4561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7801 N RICHLAND BLVD",
            "city": "NORTH RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761806415",
            "telephone_number": "469-307-4561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6350 Winter Park Dr",
            "address_purpose": "LOCATION",
            "city": "North Richland Hills",
            "state": "TX",
            "postal_code": "761805363",
            "country_code": "US",
            "telephone_number": "469-307-4561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALENZUELA",
        "first_name": "BRE'ANNA",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-21",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "111924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Richland Hills, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.