Active NPI
Myra Mata
- Behavior Analyst
- Plano, TX
National Provider Identifier
1205422136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 4639
- Practice address
- 5400 W Plano Pkwy Ste 200
Plano, TX 75093-4855 - Phone
- (972) 665-7251
- NPI assigned
- Dec 15, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 00010707 | TX | |
| Behavior Analyst | 103K00000X | 4639 | TX | Primary |
Addresses
Primary practice location
5400 W Plano Pkwy Ste 200
Plano, TX 75093-4855
Mailing address
18726 S Western Ave Ste 408
Gardena, CA 90248-3858
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 |
|---|---|---|---|
| 4639 | TX | MD | Marriage & Family Therapist |
| 00010707 | TX | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavior Frontiers, LLC | Behavior Analyst | Past | Accepting new patients |
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.
-
- Behavior Analyst
- Gardena, CA
- NPI 1245539394
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641945600000",
"number": "1205422136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18726 S WESTERN AVE STE 408",
"city": "GARDENA",
"state": "CA",
"postal_code": "902483858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5400 W PLANO PKWY STE 200",
"city": "PLANO",
"state": "TX",
"postal_code": "750934855",
"telephone_number": "972-665-7251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATA",
"first_name": "MYRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-15",
"last_updated": "2022-01-12",
"certification_date": "2022-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "TX",
"license": "00010707",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TX",
"license": "4639",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.