Individual provider Active NPI

Theresa Marie Kundrot, M.A. CCC-SLP

  • Speech-Language Pathologist
  • Houston, TX
National Provider Identifier
1811254352
Registry record updated Apr 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
103542 Issued in TX
Practice address
1234 Bay Area Blvd
Houston, TX 77058-2538
Phone
(281) 488-7221
NPI assigned
Apr 23, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2012

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 103542 TX Primary

Addresses

Primary practice location

1234 Bay Area Blvd
Houston, TX 77058-2538

Mailing address

16538 Town Lake CT
Houston, TX 77059-5545
Phone (281) 286-5178

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
103542TXMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335139200000",
    "number": "1811254352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16538 TOWN LAKE CT",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770595545",
            "telephone_number": "281-286-5178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 BAY AREA BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770582538",
            "telephone_number": "281-488-7221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNDROT",
        "first_name": "THERESA",
        "middle_name": "MARIE",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-23",
        "last_updated": "2012-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "103542",
            "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 Apr 23, 2012; 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.