MEDICARE: AUSTIN BEHAVIOR GROUP LLC

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1205793411
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUSTIN BEHAVIOR GROUP LLC

Provider Business Mailing Address
First Line	:	205 AGAVE BLOOM COVE
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78738-1802
Country	:	US
Telephone Number	:	410-652-7335
Fax Number	:

Provider Business Practice Location Address
First Line	:	205 AGAVE BLOOM COVE
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78738-1802
Country	:	US
Telephone Number	:	410-652-7335
Fax Number	:

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MR. TODD CLIFFORD SHILOW JR.
Credential	:
Telephone Number	:	410-652-7335

Provider Enumeration Date	:	01/08/2026
Last Update Date	:	01/08/2026

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