Active NPI
Angel Edwards
- Behavior Technician
- Gatesville, TX
National Provider Identifier
1205375334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 16-25740
- Practice address
- 136 North 28TH Street
Gatesville, TX 76528 - Phone
- (719) 217-1030
- NPI assigned
- Feb 22, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | 16-25740 | GA | Primary |
Addresses
Primary practice location
136 North 28TH Street
Gatesville, TX 76528
Mailing address
136 North 28TH Street
Gatesville, TX 76528
Phone (719) 217-1030
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 |
|---|---|---|---|
| 16-25740 | GA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487721600000",
"number": "1205375334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "136 NORTH 28TH STREET",
"city": "GATESVILLE",
"state": "TX",
"postal_code": "76528",
"telephone_number": "719-217-1030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "136 NORTH 28TH STREET",
"city": "GATESVILLE",
"state": "TX",
"postal_code": "76528",
"telephone_number": "719-217-1030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "ANGEL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-02-22",
"last_updated": "2017-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "GA",
"license": "16-25740",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gatesville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.