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NPI Code Detail

MEDICARE: ABBIE GALLMAN BCBA

MEDICARE: ABBIE GALLMAN 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
1103K00000XBehavior Analyst1-24-75659TX

General Provider Information

NPI Number : 1750108429
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABBIE GALLMAN BCBA
Provider Business Mailing Address
First Line : 2417 PRESIDIO VISTA DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76177-8275
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2417 PRESIDIO VISTA DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76177-8275
Country : US
Telephone Number : 817-886-0088
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2024
Last Update Date : 09/24/2024

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