Active NPI
Virginia Niccole Diaz de Leon, M.S.
- Speech-Language Pathologist
- Humble, TX
National Provider Identifier
1851788541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 111086
- Practice address
- 19411 McKay Dr
Suite 300
Humble, TX 77338-5713 - Phone
- (361) 537-6242
- NPI assigned
- Apr 20, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 111086 | TX | Primary |
Addresses
Primary practice location
19411 McKay Dr
Suite 300
Humble, TX 77338-5713
Mailing address
1760 Barker Cypress Rd Apt 1523
Houston, TX 77084-6193
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 111086 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429488000000",
"number": "1851788541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1760 BARKER CYPRESS RD APT 1523",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770846193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19411 MCKAY DR",
"address_2": "SUITE 300",
"city": "HUMBLE",
"state": "TX",
"postal_code": "773385713",
"telephone_number": "361-537-6242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ DE LEON",
"first_name": "VIRGINIA",
"middle_name": "NICCOLE",
"credential": "M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-20",
"last_updated": "2015-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "111086",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Humble, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.