Active NPI
Ngoc M Phan, BCBA
- Behavior Analyst
- Irving, TX
National Provider Identifier
1255720207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BACB239316
- Practice address
- 400 E Royal LN Ste 290
Irving, TX 75039-3602 - Phone
- (855) 832-6727
- NPI assigned
- Jan 14, 2015
- 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 Analyst | 103K00000X | BACB239316 | TX | Primary |
Addresses
Primary practice location
400 E Royal LN Ste 290
Irving, TX 75039-3602
Mailing address
400 E Royal LN Ste 290
Irving, TX 75039-3602
Other practice location 1
3350 Flamingo Basin
San Antonio, TX 78247-6514
Phone (210) 643-7959
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 |
|---|---|---|---|
| BACB239316 | TX | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494806400000",
"number": "1255720207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 E ROYAL LN STE 290",
"city": "IRVING",
"state": "TX",
"postal_code": "750393602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 E ROYAL LN STE 290",
"city": "IRVING",
"state": "TX",
"postal_code": "750393602",
"telephone_number": "855-832-6727"
}
],
"practiceLocations": [
{
"address_1": "3350 Flamingo Basin",
"address_purpose": "LOCATION",
"city": "San Antonio",
"state": "TX",
"postal_code": "782476514",
"country_code": "US",
"telephone_number": "210-643-7959",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PHAN",
"first_name": "NGOC",
"middle_name": "M",
"credential": "BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-14",
"last_updated": "2017-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TX",
"license": "BACB239316",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irving, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.