Individual provider Active NPI

Keila Pavon

  • Behavior Analyst
  • San Antonio, TX
National Provider Identifier
1780397950
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
8432 Issued in TX
Practice address
5720 Bandera Rd Ste 21
San Antonio, TX 78238-1985
Phone
(210) 817-8525
Fax
(210) 729-7397
NPI assigned
Jan 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 8432 TX Primary

Addresses

Primary practice location

5720 Bandera Rd Ste 21
San Antonio, TX 78238-1985

Mailing address

5720 Bandera Rd Ste 21
San Antonio, TX 78238-1985
Phone (210) 817-8525

Other practice location 1

3700 Ridge Country St
San Antonio, TX 78247-3463
Phone (210) 598-7212

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

LicenseStateTypeSpecialty
8432TXMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Adventure Sprouts Kids Therapy PLLC CurrentSince Dec 7, 2025 Accepting new patients
Promise Center for Autism, LLC Behavior Analyst PastSince Jan 1, 2023 Accepting new patients

Locations

5720 Bandera Rd
Ste 21
San Antonio, TX 78238
Phone (210) 712-6419

Organizations & group practices 2

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": "1672704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1780397950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5720 BANDERA RD STE 21",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782381985",
            "telephone_number": "210-817-8525",
            "fax_number": "210-729-7397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5720 BANDERA RD STE 21",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782381985",
            "telephone_number": "210-817-8525",
            "fax_number": "210-729-7397"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3700 Ridge Country St",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782473463",
            "country_code": "US",
            "telephone_number": "210-598-7212",
            "fax_number": "866-811-2590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAVON",
        "first_name": "KEILA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-03",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "8432",
            "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 May 20, 2025; 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.