NPIMap

Organization Active NPI

Star Light Speech Therapy Services

  • Speech-Language Pathologist
  • Mesquite, TX
National Provider Identifier
1922341213
Registry record updated Apr 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
105956 Issued in TX
Legal business name
STAR LIGHT SPEECH THERAPY SERVICES
Practice address
1308 Matthew Dr
Mesquite, TX 75149-7700
Phone
(773) 640-8340
NPI assigned
Apr 4, 2013
Last updated
Apr 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2013

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

Authorized official

Name
Eddwado Perkin, M.S. CCC-SLPNPI 1649513383
Title
Owner
Phone
(773) 640-8340

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 105956 TX Primary

Addresses

Primary practice location

1308 Matthew Dr
Mesquite, TX 75149-7700

Mailing address

1308 Matthew Dr
Mesquite, TX 75149-7700
Phone (773) 640-8340

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1365033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365033600000",
    "number": "1922341213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 MATTHEW DR",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751497700",
            "telephone_number": "773-640-8340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 MATTHEW DR",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751497700",
            "telephone_number": "773-640-8340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAR LIGHT SPEECH THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-04",
        "last_updated": "2013-04-04",
        "status": "A",
        "authorized_official_last_name": "PERKIN",
        "authorized_official_first_name": "EDDWADO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-640-8340",
        "authorized_official_credential": "M.S. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "105956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2013; 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.