Individual provider Active NPI

Abigail Trese Burklow, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Amarillo, TX
National Provider Identifier
1912379330
Registry record updated Oct 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
109014 Issued in TX
Practice address
600 S Tyler St
Suite 805
Amarillo, TX 79101-2353
Phone
(806) 553-7780
NPI assigned
Oct 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2015

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 109014 TX Primary

Addresses

Primary practice location

600 S Tyler St
Suite 805
Amarillo, TX 79101-2353

Mailing address

1310 23Rd St Apt 703
Canyon, TX 79015-5328
Phone (806) 654-5688

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

LicenseStateTypeSpecialty
109014TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1445731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445731200000",
    "number": "1912379330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 23RD ST APT 703",
            "city": "CANYON",
            "state": "TX",
            "postal_code": "790155328",
            "telephone_number": "806-654-5688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S TYLER ST",
            "address_2": "SUITE 805",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791012353",
            "telephone_number": "806-553-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKLOW",
        "first_name": "ABIGAIL",
        "middle_name": "TRESE",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-25",
        "last_updated": "2015-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "109014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.

Verify at the official NPI Registry.