Individual provider Active NPI

Tasneem Bakhach

  • Behavior Technician
  • Grand Prairie, TX
National Provider Identifier
1114535309
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-20-127808 Issued in TX
Practice address
4927 Lake Ridge Pkwy Ste 120
Grand Prairie, TX 75052-3066
Phone
(214) 251-8758
NPI assigned
Jul 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-20-127808 TX Primary

Addresses

Primary practice location

4927 Lake Ridge Pkwy Ste 120
Grand Prairie, TX 75052-3066

Mailing address

4927 Lake Ridge Pkwy Ste 120
Grand Prairie, TX 75052-3066

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

State licenses

LicenseStateTypeSpecialty
RBT-20-127808TXMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1114535309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4927 LAKE RIDGE PKWY STE 120",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750523066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4927 LAKE RIDGE PKWY STE 120",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750523066",
            "telephone_number": "214-251-8758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKHACH",
        "first_name": "TASNEEM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-14",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "TX",
            "license": "RBT-20-127808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; 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.