Individual provider Active NPI

Jeremiah Anzualda, BCBA

  • Behavior Analyst
  • Sugar Land, TX
National Provider Identifier
1366084410
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
3071 Issued in TX
Practice address
6914 Brisbane CT Ste 200
Sugar Land, TX 77479-4924
Phone
(844) 272-7223
NPI assigned
Oct 10, 2019
Last updated
Feb 27, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 3071 TX Primary

Addresses

Primary practice location

6914 Brisbane CT Ste 200
Sugar Land, TX 77479-4924

Mailing address

6914 Brisbane CT Ste 200
Sugar Land, TX 77479-4924
Phone (844) 272-7223

Other practice location 1

12711 Telge Rd Ste 400
Cypress, TX 77429-1938
Phone (844) 272-7223

Other practice location 2

2051 Greenhouse Rd Ste 160
Houston, TX 77084-8022
Phone (844) 272-7223

Other practice location 3

1050 N Post Oak Rd Ste 160
Houston, TX 77055-7233
Phone (844) 272-7223

Other practice location 4

4710 Bellaire Blvd Ste 150
Bellaire, TX 77401-4589
Phone (844) 272-7223

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
3071TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Asd Therapy Solutions, LLC Behavior Analyst Past Accepting new patients
Apara Autism Center PastSince Oct 22, 2023 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1366084410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6914 BRISBANE CT STE 200",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774794924",
            "telephone_number": "844-272-7223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6914 BRISBANE CT STE 200",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774794924",
            "telephone_number": "844-272-7223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12711 Telge Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Cypress",
            "state": "TX",
            "postal_code": "774291938",
            "country_code": "US",
            "telephone_number": "844-272-7223",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2051 Greenhouse Rd Ste 160",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770848022",
            "country_code": "US",
            "telephone_number": "844-272-7223",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1050 N Post Oak Rd Ste 160",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770557233",
            "country_code": "US",
            "telephone_number": "844-272-7223",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4710 Bellaire Blvd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Bellaire",
            "state": "TX",
            "postal_code": "774014589",
            "country_code": "US",
            "telephone_number": "844-272-7223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANZUALDA",
        "first_name": "JEREMIAH",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-10",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "3071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.

Verify at the official NPI Registry.