Active NPI
Jacob Ray Watson
- Behavior Analyst
- San Antonio, TX
National Provider Identifier
1710485354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-20-42381
- Practice address
- 9274 Ingleton
San Antonio, TX 78245-1659 - Phone
- (210) 672-0564
- NPI assigned
- Jan 29, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-17-36085 | TX | |
| Behavior Analyst | 103K00000X | 1-20-42381 | TX | Primary |
Addresses
Primary practice location
9274 Ingleton
San Antonio, TX 78245-1659
Mailing address
14317 Potranco Roard Suite 205, #327
San Antonio, TX 78253
Phone (210) 672-0564
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-17-36085 | TX | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676851200000",
"number": "1710485354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14317 POTRANCO ROARD SUITE 205, #327",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78253",
"telephone_number": "210-672-0564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9274 INGLETON",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782451659",
"telephone_number": "210-672-0564"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATSON",
"first_name": "JACOB",
"middle_name": "RAY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-29",
"last_updated": "2023-02-20",
"certification_date": "2020-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "TX",
"license": "RBT-17-36085",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TX",
"license": "1-20-42381",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.