Individual provider Active NPI

Tyler Lee Walsh

  • Behavior Analyst
  • Houston, TX
National Provider Identifier
1376109330
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
6612 Issued in TX
Practice address
14536 Memorial Dr
Houston, TX 77079-5431
Phone
(281) 845-8711
NPI assigned
May 15, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X TX
Behavior Analyst 103K00000X 6612 TX Primary

Addresses

Primary practice location

14536 Memorial Dr
Houston, TX 77079-5431

Mailing address

14536 Memorial Dr
Houston, TX 77079-5431
Phone (281) 845-8711

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
6612TXMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1376109330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14536 MEMORIAL DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770795431",
            "telephone_number": "281-845-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14536 MEMORIAL DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770795431",
            "telephone_number": "281-845-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "TYLER",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-15",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "6612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.