MEDICARE: AVERY ANN CAMPBELL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106E00000X	Assistant Behavior Analyst	0-26-17048	TX

General Provider Information

NPI Number	:	1174465769
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AVERY ANN CAMPBELL

Provider Business Mailing Address
First Line	:	16027 ASHVALE DR
Second Line	:
City	:	TOMBALL
State	:	TX
Zip	:	77377-9316
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7630 DOWDELL RD
Second Line	:
City	:	TOMBALL
State	:	TX
Zip	:	77375
Country	:	US
Telephone Number	:	346-376-3381
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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Directions to “ AVERY ANN CAMPBELL ” Practice Location

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