Active NPI
Lucy Diaz Perez
- Behavior Technician
- Venus, TX
National Provider Identifier
1114759933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-24-336533
- Practice address
- 2400 Ellis St Ste 1
Venus, TX 76084-3390 - Phone
- (682) 877-1234
- NPI assigned
- Aug 19, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-24-336533 | TX | Primary |
Addresses
Primary practice location
2400 Ellis St Ste 1
Venus, TX 76084-3390
Mailing address
637 Samuels Ave Apt 3036
Fort Worth, TX 76102-1446
Phone (470) 424-0069
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-24-336533 | TX | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Embrace ABA, PLLC | Current | Accepting new patients |
Locations
2400 Ellis St
Ste 1
Venus, TX 76084
Phone (682) 877-1234
Organizations & group practices 1
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.
-
- Adolescent and Children Mental Health Clinic/Center
- Venus, TX
- NPI 1699492074
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724025600000",
"number": "1114759933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "637 SAMUELS AVE APT 3036",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761021446",
"telephone_number": "470-424-0069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 ELLIS ST STE 1",
"city": "VENUS",
"state": "TX",
"postal_code": "760843390",
"telephone_number": "682-877-1234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ PEREZ",
"first_name": "LUCY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-19",
"last_updated": "2024-08-19",
"certification_date": "2024-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "TX",
"license": "RBT-24-336533",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Venus, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.