Poonam Mittal

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

400 E Royal LN BLDG 3
Irving, TX 75039-3540

Phone

(852) 832-5727

NPI assigned

Oct 8, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1538956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1386119246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 BAY CIR",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750193131",
            "telephone_number": "856-673-6473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E ROYAL LN BLDG 3",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750393540",
            "telephone_number": "852-832-5727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTAL",
        "first_name": "POONAM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-08",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "W243494096",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "W243494096",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aakash Mistry
• Parthiv Mistry
• Byron Lyle Mitchell, D.D.S.
• John Keith Mitchell, DDS
• Micah James Mitchell, MBA, ATP
• Michelle M. Mizrachi, M.D.
• MJ Weaver Corp
• Mju Home Health Care
• Moda Counseling, PLLC
• Stephanie Modarelli, LCSW, LCDC

• Behavior Analyst in Irving, TX
• Providers in Irving, TX by specialty
• Behavior Analyst in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2018; 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.