Active NPI
Eileen Minerva Macias-Mendoza, MA, BCBA, LBA
- Behavior Analyst
- Round Rock, TX
National Provider Identifier
1689493751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 7418
- Practice address
- 104 Northwest Dr
Round Rock, TX 78664-4250 - Phone
- (714) 984-7645
- NPI assigned
- Oct 7, 2024
- 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 | 7418 | TX | Primary |
Addresses
Primary practice location
104 Northwest Dr
Round Rock, TX 78664-4250
Mailing address
3147 Jazz St
Round Rock, TX 78664-7218
Phone (714) 984-7645
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7418 | TX | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Austin Connect to Wellness, LLC | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728259200000",
"number": "1689493751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3147 JAZZ ST",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "786647218",
"telephone_number": "714-984-7645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 NORTHWEST DR",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "786644250",
"telephone_number": "714-984-7645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACIAS-MENDOZA",
"first_name": "EILEEN",
"middle_name": "MINERVA",
"credential": "MA, BCBA, LBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-07",
"last_updated": "2024-10-07",
"certification_date": "2024-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TX",
"license": "7418",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Round Rock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.