WEST TEXAS A & M UNIVERSITY (NPI# 1194083311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194083311 |
| Entity Type | Organization |
| Organization Name | WEST TEXAS A & M UNIVERSITY |
| Other Organization Name | SPEECH & HEARING CLINIC |
| Practice Address |
2501 4th Ave Canyon TX 79016-0001 |
| Mailing Address |
Wtamu Box 60757 Canyon TX 79016-0001 |
| Practice Telephone | 8066515108 |
| Mailing Telephone | 8066515108 |
| Mailing Fax Number | 8066515105 |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2016-05-27 |
| Authorized Official Name | DR. BRENDA F CROSS (DEPARTMENT HEAD) |
| Authorized Official Telephone | 8066515108 |
| Authorized Official Credential | AUD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0700X |
Clinic/Center Specialization: Hearing and Speech |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Speech & Hearing Clinic | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | WEST TEXAS A & M UNIVERSITY | 2501 4th Ave, Canyon, TX 79016-0002 |
| Street Address |
2501 4TH AVE |
| City | CANYON |
| State | TX |
| Zip Code | 79016-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235387184 | Traci B Fredman | Speech-Language Pathologist | 2501 4th Ave, Canyon, TX 79016-0001 | 2008-09-04 |
| 1821469487 | Noel Francis Clifton | Speech-Language Pathologist | 2501 4th Ave, Canyon, TX 79016-0001 | 2015-10-08 |
| 1669881017 | Jeffrey Case | Specialist/Technologist | 2501 4th Ave, Canyon, TX 79016-0001 | 2014-08-11 |
| 1043571938 | Leslie W Dalton Jr. | Audiologist | 2501 4th Ave, Canyon, TX 79016-0001 | 2012-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912920844 | Candy C Marshall | Nurse Practitioner | 2620 Russell Long Blvd, Canyon, TX 79016 | 2006-07-25 |
| 1811400666 | Tracey Dianne Ecklund | Student in an Organized Health Care Education/Training Program | 2620 Russel Long Blvd, Canyon, TX 79016-0001 | 2017-11-14 |
| 1689014326 | Lorna Strong | Specialist/Technologist | 2342 Russell Long Blvd, Virgil Henson Activities Center 217, Canyon, TX 79016-0001 | 2013-06-26 |
| 1790971224 | Sally Lynn Gaines | Student in an Organized Health Care Education/Training Program | West Texas A & M University, Old Main, Room 308-a, Canyon, TX 79016-0001 | 2007-09-19 |
| 1639394984 | Robby Douglas Rhodes | Specialist/Technologist | 60216 Wtamu, Canyon, TX 79016-0001 | 2007-04-13 |
| 1992869929 | James Edward Gibbs | Family Medicine | Student Medical Services, 2620 Russell Long Blvd., Canyon, TX 79016-0001 | 2006-12-21 |
| 1407967599 | West Texas A&m University Student Medical Services | Clinic/Center | 2620 N Russel Long Blvd, Virgil Henson Activities Center Room 104, Canyon, TX 79016-0001 | 2006-08-31 |
| 1245341692 | Wendy L Bertram | Nurse Practitioner | 2620 N. Russell Long Blvd, Canyon, TX 79016-0001 | 2006-08-31 |
| 1376526129 | Karen Elizabeth Knapp | Nurse Practitioner | Wt Box 61401, Canyon, TX 79016-0001 | 2005-11-25 |
| 1912410762 | Heather Ann Ferrell | Specialist/Technologist | 2620 Russel Long Blvd, Canyon, TX 79016-0001 | 2017-11-14 |
| Find all providers in zip 79016 | ||||
| Taxonomy Code | 261QH0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Hearing and Speech |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, prescriptive, and therapy services related to congenital and acquired conditions and diseases that affect hearing capacity and speech ability. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487255832 | Beeville Hearing Center LLC | Clinic/Center | 2012 N Saint Marys St Ste B, Beeville, TX 78102-2409 | 2020-11-03 |
| 1194325787 | Heather Cecile Simien | Clinic/Center | 2700 Bellefontaine St Apt A22, Houston, TX 77025-1673 | 2020-11-01 |
| 1497355507 | Phebe Bubel | Clinic/Center | 12223 Salt River Valley Ln, Humble, TX 77346-2967 | 2020-10-28 |
| 1154938256 | Lejeune Holdings LLC | Clinic/Center | 6810 Castle Hollow Dr, Spring, TX 77389-1412 | 2020-09-23 |
| 1316553365 | Trusted Hearing Center LLC | Clinic/Center | 4859 Williams Dr Ste 109, Georgetown, TX 78633-2304 | 2020-09-16 |
| 1467065268 | Main Step Therapy LLC | Clinic/Center | 12214 Maplecrest Dr, Frisco, TX 75035-0908 | 2020-08-31 |
| 1265045579 | Snj Aba LLC | Clinic/Center | 13333 Nw Fwy Ste 130, Houston, TX 77040-6009 | 2020-08-26 |
| 1770119059 | Jason Thomas Van Buren | Clinic/Center | 1606 Norwood St, Deer Park, TX 77536-3718 | 2020-03-18 |
| 1275179855 | Ippolito Speech-language Therapy Services, P.l.l.c. | Clinic/Center | 1200 Main St Apt 1001, Dallas, TX 75202-4303 | 2019-11-19 |
| 1609438944 | Hope Rising Speech Therapy & Educational Services Pllc | Clinic/Center | 301 Glenn Ave, Rockwall, TX 75087-4146 | 2019-07-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.