=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831057439
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JENA HERMES M.S., CCC-SLP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/12/2026
-----------------------------------------------------
Last Update Date | 01/12/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18931 HARDY OAK BLVD
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78258-4966
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-743-6802
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 320 COUNTY ROAD 378H
-----------------------------------------------------
City | HALLETTSVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77964-5655
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 361-772-7506
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | 121608
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------