Elizabeth Surita-Khuat, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

102938 Issued in TX

Practice address

215 NE 14TH St
Fort Worth, TX 76164-8901

Phone

(817) 846-5442

NPI assigned

Apr 23, 2016

Last updated

Sep 22, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1461369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1841645173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6817 MULESHOE LN",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761792583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 NE 14TH ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761648901",
            "telephone_number": "817-846-5442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2701 Airport Fwy",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761112378",
            "country_code": "US",
            "telephone_number": "682-564-5476",
            "fax_number": "682-292-2930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SURITA-KHUAT",
        "first_name": "ELIZABETH",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-23",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "102938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Surgical Caregivers of Fort Worth LLC (Texas Health Surgery Center Fort Worth Midtown)
• Surgical Nurse First Assist, PC
• Surgical Services Group, Inc
• Surgicalist of TX PLLC
• Vidya Sri Suri, DDS
• Blaire Surley, OTR, CBIS
• Jeremy Lee Surratt
• Sajid Ali Surve, DO
• Survivor Gals Specialty Products and Salon LLC (Survivor Gals Specialty Products Fort Worth)
• Susan Arnold Lange, Psychologist, LPPC

• Speech-Language Pathologist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; 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.