Jose Alfredo Jimenez Jr., M.ED.

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

13362 Issued in TX

Practice address

105 Kathryn Dr
BLDG 3, Ste D
Lewisville, TX 75067-4216

Phone

(800) 972-0643

NPI assigned

Feb 23, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

Practice roles

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.

• Rayl Enterprises

  dba Grace Counseling Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Fort Worth, TX
  • NPI 1891044228

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1456185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456185600000",
    "number": "1730549478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 LAKESIDE CIR APT 1333",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750575105",
            "telephone_number": "214-708-6268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 KATHRYN DR",
            "address_2": "BLDG 3, STE D",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750674216",
            "telephone_number": "800-972-0643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "JOSE",
        "middle_name": "ALFREDO",
        "name_suffix": "Jr.",
        "credential": "M.ED.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-23",
        "last_updated": "2016-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "13362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Britany Rae Jenkins
• Jinseon Jeong, OD
• Jesus Take the Wheel, LLC
• Jibron Int'L Inc (Sweet Spring Healthcare Services)
• Amanda Villalobos Jimenez Lawson, MD
• Jmax LLC
• Joanna Eernisse, PLLC (Just Be You., Psychiatry)
• Mary F. Jocius, CRNA
• Joffy International Inc
• Joffy International Inc

• Addiction (Substance Use Disorder) Counselor in Lewisville, TX
• Providers in Lewisville, TX by specialty
• Addiction (Substance Use Disorder) Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; 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.