Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1104743863 Individual Practitioner Female Practitioner

Blake Nicole Gibson , MS, CCC-SLP

Speech-Language Pathologist • Fort Worth, TX

Professional Overview & Biography Verified Profile Summary

Blake Gibson, MS, CCC-SLP is a registered healthcare professional specializing in Speech-Language Pathologist in Fort Worth, TX. Practice services are available at 4901 BRYANT IRVIN RD N STE 200 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4901 Bryant Irvin Rd N Ste 200

Fort Worth, TX 761077673

Telephone 8174339742

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Fort Worth, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 11.9 Yrs
State Avg: 14.3 Yrs
Regional Practice Density
694 Specialists

Practicing in Fort Worth, TX (17210 Statewide)

Telehealth Adoption Rate
0.3% 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: 2026-07-02
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License TX 122638

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.

Practice Associates & Co-Workers

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

18 Associated Practitioners
Selena Elerson

Physical Therapist

NPI 1043050743
Dr. Duncan Simoneaux , DPT

Physical Therapist

NPI 1063177780

Doctor of Physical Therapy

Otugo Ananaba

Physical Therapist

NPI 1063392785
Erica Zettlemoyer , PT

Physical Therapist

NPI 1124495114

Physical Therapist

Deborah Dahn , PT

Physical Therapist

NPI 1174088645

Physical Therapist

Isael Marquez , OTR

Occupational Therapist

NPI 1184960197

Occupational Therapist Registered

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active July 02, 2026

NPI status registered as active in NPPES database

📍
Updated Practice Location July 02, 2026

Registered at 4901 BRYANT IRVIN RD N STE 200, FORT WORTH, TX 761077673 (Tel: 8174339742)

📍
Updated Business Mailing Address July 02, 2026

Registered at 10917 LOS RIOS DR, FORT WORTH, TX 761796842

👤
Provider Name / Credentials Updated July 02, 2026

Recorded as BLAKE GIBSON, M.S., CCC-SLP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 02, 2026

Speech-Language Pathologist (License #122638 in TX)

🟢
Initial NPI Registration & Enumeration July 02, 2026

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: 1104743863
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 02, 2026
Last Update: July 02, 2026
Sole Proprietor: No

Mailing Address

10917 Los Rios Dr

Fort Worth, TX 761796842

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.