Individual provider Active NPI

Ivan Mejia, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Houston, TX
National Provider Identifier
1972648855
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
102518 Issued in TX
Practice address
9894 Bissonnet St.
Ste. 388
Houston, TX 77036
Phone
(713) 429-1176
Fax
(832) 252-9263
NPI assigned
Feb 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2024

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 102518 TX Primary

Addresses

Primary practice location

9894 Bissonnet St.
Ste. 388
Houston, TX 77036

Mailing address

9894 Bissonnet St Ste 388
Houston, TX 77036-8273
Phone (713) 429-1176

Other identifiers 1

IdentifierTypeStateIssuer
183948201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131009001194 TX Practitioner - Qualified Speech Language Pathologist 3678707502 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Bilingual Speech Therapy of Houston Speech-Language Pathologist CurrentSince Oct 13, 2013 Accepting new patients

Locations

6666 Harwin Dr
Ste 158
Houston, TX 77036
Phone (713) 429-1176

6666 Harwin Dr
Ste 490
Houston, TX 77036
Phone (713) 429-1176

9894 Bissonnet St
Ste 388
Houston, TX 77036
Phone (713) 429-1176

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": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1972648855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9894 BISSONNET ST STE 388",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770368273",
            "telephone_number": "713-429-1176",
            "fax_number": "832-252-9263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9894 BISSONNET ST.",
            "address_2": "STE. 388",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77036",
            "telephone_number": "713-429-1176",
            "fax_number": "832-252-9263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEJIA",
        "first_name": "IVAN",
        "name_prefix": "Mr.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "102518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183948201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; 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.

Verify at the official NPI Registry.