Angela Wilburn-Porras, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-12-47863 Issued in TX

Practice address

6211 Southwest Blvd
Benbrook, TX 76132-1080

Phone

(817) 691-3283

NPI assigned

Feb 15, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1550188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1902362874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16800 DALLAS PKWY STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6211 SOUTHWEST BLVD",
            "city": "BENBROOK",
            "state": "TX",
            "postal_code": "761321080",
            "telephone_number": "817-691-3283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBURN-PORRAS",
        "first_name": "ANGELA",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-15",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": "RT-18-52660",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "1-12-47863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BACB",
            "identifier": "1-12-47863",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BACB",
            "identifier": "RT-18-52660",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Benbrook, TX
• Providers in Benbrook, TX by specialty
• Behavior Analyst in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; 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.