Individual provider Active NPI

Innocent Brendan Usoro

  • Behavior Technician
  • Houston, TX
National Provider Identifier
1043974199
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
12202 Dover St
Houston, TX 77031-2826
Phone
(713) 498-6409
NPI assigned
Oct 25, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

12202 Dover St
Houston, TX 77031-2826

Mailing address

12603 Southwest Fwy Ste 695
Stafford, TX 77477-3838

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL 3invest30@gmail.com
CONNECT URL Servers Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rising Stars ABA, Inc. Behavior Analyst CurrentSince May 16, 2022 Accepting new patients
Raising Star Transportation Inc Current Accepting new patients

Locations

12603 Southwest Fwy
Ste 695
Stafford, TX 77477
Phone (832) 318-5145

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1043974199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12603 SOUTHWEST FWY STE 695",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774773838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12202 DOVER ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770312826",
            "telephone_number": "713-498-6409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "USORO",
        "first_name": "INNOCENT",
        "middle_name": "BRENDAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-25",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "3invest30@gmail.com",
            "affiliation": "N",
            "address_1": "12603 Southwest Fwy Ste 695",
            "city": "Stafford",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774773838",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Servers",
            "affiliation": "N",
            "endpointDescription": "Tablets, desktops, laptops",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Communication",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12603 Southwest Fwy Ste 695",
            "city": "Stafford",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774773838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; 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.