Active NPI
Polette Zimmerman
- Behavior Technician
- Sugar Land, TX
National Provider Identifier
1760179618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 20-119899
- Practice address
- 2115 Collingsfield Dr
Sugar Land, TX 77478-6021 - Phone
- (832) 931-1665
- NPI assigned
- Apr 20, 2023
- Sex
- Female
- Sole proprietor
- No
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 Technician | 106S00000X | 20-119899 | TX | Primary |
Addresses
Primary practice location
2115 Collingsfield Dr
Sugar Land, TX 77478-6021
Mailing address
2115 Collingsfield Dr
Sugar Land, TX 77478-6021
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 |
|---|---|---|---|
| 20-119899 | TX | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681948800000",
"number": "1760179618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2115 COLLINGSFIELD DR",
"city": "SUGAR LAND",
"state": "TX",
"postal_code": "774786021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2115 COLLINGSFIELD DR",
"city": "SUGAR LAND",
"state": "TX",
"postal_code": "774786021",
"telephone_number": "832-931-1665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZIMMERMAN",
"first_name": "POLETTE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-20",
"last_updated": "2023-04-20",
"certification_date": "2023-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "TX",
"license": "20-119899",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sugar Land, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 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.