MEDICARE: NATA DZADZAMIA BCBA

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	:	1265379291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATA DZADZAMIA BCBA

Provider Business Mailing Address
First Line	:	5602 PRESIDIO PKWY APT 2407
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-3174
Country	:	US
Telephone Number	:	512-506-0952
Fax Number	:

Provider Business Practice Location Address
First Line	:	1255 SW LOOP 410 STE 151
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78227-1667
Country	:	US
Telephone Number	:	726-900-8993
Fax Number	:

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

Provider Enumeration Date	:	04/29/2026
Last Update Date	:	04/29/2026

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Directions to “ NATA DZADZAMIA BCBA” Practice Location

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