NPIMap

Organization Active NPI

Beacon Behavioral of Texas PA

  • Psychiatry Physician
  • Cedar Park, TX
National Provider Identifier
1831934009
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
BEACON BEHAVIORAL OF TEXAS PA
Practice address
11901 W Parmer LN Ste 310
Cedar Park, TX 78613-7654
Phone
(512) 528-9498
Fax
(512) 843-7164
NPI assigned
Jun 28, 2024
Organization subpart
Yes
Parent organization
BEACON BEHAVIORAL OF TEXAS PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Authorized official

Name
Kimberly Glaveskas
Title
Credentialing Supervisor
Phone
(214) 550-7536

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

11901 W Parmer LN Ste 310
Cedar Park, TX 78613-7654

Mailing address

11901 W Parmer LN Ste 310
Cedar Park, TX 78613-7654
Phone (512) 528-9498

Other names 1

  • Earthman / Cedar Park TMS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Beacon Behavioral of TX PA7 organizations share this tax ID, including this one
Part of
Beacon Behavioral of TX PA

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1719532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727395200000",
    "number": "1831934009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11901 W PARMER LN STE 310",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786137654",
            "telephone_number": "512-528-9498",
            "fax_number": "512-843-7164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11901 W PARMER LN STE 310",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786137654",
            "telephone_number": "512-528-9498",
            "fax_number": "512-843-7164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON BEHAVIORAL OF TEXAS PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BEACON BEHAVIORAL OF TEXAS PA",
        "enumeration_date": "2024-06-28",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A",
        "authorized_official_last_name": "GLAVESKAS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "214-550-7536"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Earthman / Cedar Park TMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cedar Park, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.