Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1568717155 Individual Practitioner Female Practitioner

Jacey Layne Bullock , MS, CCC-SLP

Speech-Language Pathologist • Aledo, TX

Professional Overview & Biography Verified Profile Summary

Jacey Bullock, MS, CCC-SLP is a registered healthcare professional specializing in Speech-Language Pathologist in Aledo, TX. Practice services are available at 1015 CHAMPIONS DR # 102 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1015 Champions Dr # 102

Aledo, TX 760083206

Telephone 2148031699
Associated Practice Facility / Clinic
🏢 Klc Pediatric Therapy, Llc Facility NPI 1306629142

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Aledo, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 14.3 Yrs
Regional Practice Density
17 Specialists

Practicing in Aledo, TX (17210 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-08-17
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License TX 36944

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
207164901 (TX)
Medicaid State Provider ID
149984001 (TX)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Bailey Travis , CCC-SLP

Speech-Language Pathologist

NPI 1619634201

Speech-Language Pathologist (Certificate of Clinical Competence)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location August 17, 2023

Registered at 1015 CHAMPIONS DR # 102, ALEDO, TX 760083206 (Tel: 2148031699)

📍
Updated Business Mailing Address August 17, 2023

Registered at 418 PRAIRIE RUN, ALEDO, TX 760081170 (Tel: 2148031699)

👤
Provider Name / Credentials Updated August 17, 2023

Recorded as JACEY BULLOCK, M.S., CCC-SLP

NPI Profile Active July 19, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location July 19, 2012

Registered at 545 ROWLETT RD, SUITE A, GARLAND, TX 750433700 (Tel: 9723037021)

📍
Updated Business Mailing Address July 19, 2012

Registered at 5316 TRAIL LAKE DR, FORT WORTH, TX 761331931 (Tel: 8172928787)

👤
Provider Name / Credentials Updated July 19, 2012

Recorded as JACEY TRAVIS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 19, 2012

Speech-Language Pathologist (License #36944 in TX)

🟢
Initial NPI Registration & Enumeration July 19, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1568717155
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 19, 2012
Last Update: August 17, 2023
Sole Proprietor: Yes

Mailing Address

418 Prairie Run

Aledo, TX 760081170

Phone: 2148031699

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.