Kelli Broussard, S.L.P.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

100265 Issued in TX

Practice address

711 W 38TH St BLDG F2
Austin, TX 78705

Phone

(512) 755-5058

Fax

(833) 964-0174

NPI assigned

Feb 22, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Austin Speech Pathology, PLLC

  • Speech-Language Pathologist
  • Austin, TX
  • NPI 1255990727
  NPD Authorized official

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

{
    "created_epoch": "1203638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1972772077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11216 DELLA TORRE DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787502810",
            "telephone_number": "512-550-6857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 W 38TH ST BLDG F2",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78705",
            "telephone_number": "512-755-5058",
            "fax_number": "833-964-0174"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10226 Kennewick Dr",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770645170",
            "country_code": "US",
            "telephone_number": "281-451-0033",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11216 Della Torre Dr",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787502810",
            "country_code": "US",
            "telephone_number": "512-550-6857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "KELLI",
        "credential": "S.L.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-22",
        "last_updated": "2023-11-27",
        "certification_date": "2020-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "100265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kelli@austinspeech.com",
            "affiliation": "Y",
            "endpointDescription": "Email",
            "affiliationName": "Austin Speech Pathology, PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "711 W 38th St Bldg F2",
            "city": "Austin",
            "state": "TX",
            "country_code": "US",
            "postal_code": "787051121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Monica M Brouillette, PT
• Aleisha Broussard
• Irene L Broussard, CRNA
• Jill Broussard, LPC
• Joel Earl Broussard Jr., DDS,MS
• Scotty Broussard, L.AC.
• Leslie Anne Broverman, RDN
• David A Browder, DPT
• Michaela Browder
• Daphne Jaguar Browell, LCDC

• Speech-Language Pathologist in Austin, TX
• Providers in Austin, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.