Healthcare Provider Details

I. General information

NPI: 1629631999
Provider Name (Legal Business Name): GARRETT BYERS BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2019
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 RICKEY AVE
FORT WALTON BEACH FL
32547-2520
US

IV. Provider business mailing address

1900 ELEVATE AVE APT G201
NAVARRE FL
32566-6971
US

V. Phone/Fax

Practice location:
  • Phone: 713-854-6655
  • Fax:
Mailing address:
  • Phone: 713-854-6655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-90763
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: