Provider Demographics
NPI:1417607987
Name:MONJARAZ, JESUS ANGEL (BEHAVIOR THERAPIST)
Entity Type:Individual
Prefix:
First Name:JESUS
Middle Name:ANGEL
Last Name:MONJARAZ
Suffix:
Gender:M
Credentials:BEHAVIOR THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19142 MISSION MANOR LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-3639
Mailing Address - Country:US
Mailing Address - Phone:281-229-0485
Mailing Address - Fax:
Practice Address - Street 1:11135 HARLEM RD STE 250
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-3657
Practice Address - Country:US
Practice Address - Phone:855-782-7822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-26
Last Update Date:2022-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician