Active NPI
Brenda Jimenez, MS CCC SLP
- Speech-Language Pathologist
- San Juan, TX
National Provider Identifier
1922485853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 113498
- Practice address
- 1205 N Raul Longoria Rd
Suite I
San Juan, TX 78589 - Phone
- (956) 782-5800
- Fax
- (956) 782-5802
- NPI assigned
- Apr 29, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | 38977 | TX | |
| Speech-Language Pathologist | 235Z00000X | 113498 | TX | Primary |
Addresses
Primary practice location
1205 N Raul Longoria Rd
Suite I
San Juan, TX 78589
Mailing address
705 Sonia Cir
Alamo, TX 78516-3749
Phone (956) 223-9337
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38977 | Other | TX | STATE LICENSE |
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 |
|---|---|---|---|
| 38977 | TX | MD | Pharmacist |
| 113498 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535414400000",
"number": "1922485853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "705 SONIA CIR",
"city": "ALAMO",
"state": "TX",
"postal_code": "785163749",
"telephone_number": "956-223-9337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1205 N RAUL LONGORIA RD",
"address_2": "SUITE I",
"city": "SAN JUAN",
"state": "TX",
"postal_code": "78589",
"telephone_number": "956-782-5800",
"fax_number": "956-782-5802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIMENEZ",
"first_name": "BRENDA",
"credential": "MS CCC SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-29",
"last_updated": "2018-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "TX",
"license": "38977",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "113498",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "38977",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Juan, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.