Active NPI
Eva M. Palacios, M.S., CCC/SLP
- Speech-Language Pathologist
- Waco, TX
National Provider Identifier
1932264264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 17042
- Practice address
- 2124 N 25TH St
Waco, TX 76708-3317 - Phone
- (254) 235-2430
- Fax
- (254) 235-2434
- NPI assigned
- Dec 27, 2006
- 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 | 17042 | TX | Primary |
Addresses
Primary practice location
2124 N 25TH St
Waco, TX 76708-3317
Mailing address
2124 N 25TH St
Waco, TX 76708-3317
Phone (254) 235-2430
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17042 | Other | TX | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17042 | TX | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kids Therapy Specialties LLC | Speech-Language Pathologist | Current | Accepting new patients |
Locations
4900 Sanger Ave
Waco, TX 76710
Phone (254) 644-2423
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322697600000",
"number": "1932264264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2124 N 25TH ST",
"city": "WACO",
"state": "TX",
"postal_code": "767083317",
"telephone_number": "254-235-2430",
"fax_number": "254-235-2434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2124 N 25TH ST",
"city": "WACO",
"state": "TX",
"postal_code": "767083317",
"telephone_number": "254-235-2430",
"fax_number": "254-235-2434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALACIOS",
"first_name": "EVA",
"middle_name": "M.",
"credential": "M.S., CCC/SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-27",
"last_updated": "2011-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "17042",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "17042",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Waco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.