Active NPI
Jose Manuel Avila, RBT
- Behavior Technician
- Dallas, TX
National Provider Identifier
1780100677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-16-13831
- Practice address
- 5580 LBJ Fwy
615
Dallas, TX 75240 - Phone
- (214) 601-4963
- NPI assigned
- Aug 22, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-16-13831 | TX | Primary |
Addresses
Primary practice location
5580 LBJ Fwy
615
Dallas, TX 75240
Mailing address
5580 LBJ Fwy
Dallas, TX 75240-6210
Phone (214) 601-4963
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-16-13831 | TX | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1780100677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5580 LBJ FWY",
"city": "DALLAS",
"state": "TX",
"postal_code": "752406210",
"telephone_number": "214-601-4963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5580 LBJ FWY",
"address_2": "615",
"city": "DALLAS",
"state": "TX",
"postal_code": "75240",
"telephone_number": "214-601-4963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVILA",
"first_name": "JOSE",
"middle_name": "MANUEL",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-22",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "TX",
"license": "RBT-16-13831",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.