NPIMap

Organization Active NPI

Idt Enterprise LLC

Doing business as Success on the Spectrum

  • Behavior Analyst
  • Desoto, TX
National Provider Identifier
1396422036
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
IDT ENTERPRISE LLC
Doing business as
Success on the Spectrum
Practice address
1510 N Hampton Rd Ste 150
Desoto, TX 75115-8324
Phone
(682) 201-7934
NPI assigned
Jul 4, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Authorized official

Name
Telema NgaNPI 1184916769
Title
Ceo
Phone
(682) 201-7934

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary
Occupational Medicine Clinic/Center 261QX0100X

Addresses

Primary practice location

1510 N Hampton Rd Ste 150
Desoto, TX 75115-8324

Mailing address

1106 Cordova St
Mansfield, TX 76063-3198
Phone (682) 201-7934

Other names 1

  • Success on the Spectrum Doing business as

National Provider Directory

National Provider Directory

Locations

1510 N Hampton Rd
Ste 150
Desoto, TX 75115
Phone (469) 659-7215

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1688428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1396422036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 CORDOVA ST",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633198",
            "telephone_number": "682-201-7934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 N HAMPTON RD STE 150",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751158324",
            "telephone_number": "682-201-7934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDT ENTERPRISE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-04",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "NGA",
        "authorized_official_first_name": "TELEMA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "682-201-7934"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Success on the Spectrum",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Success on the Spectrum",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Desoto, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; 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.