Healthcare Provider Details

I. General information

NPI: 1649835281
Provider Name (Legal Business Name): HUGO MUNOZ-HERNANDEZ BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2019
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1512 LEXINGTON RD
CLOVIS NM
88101-4418
US

IV. Provider business mailing address

1512 LEXINGTON RD
CLOVIS NM
88101-4418
US

V. Phone/Fax

Practice location:
  • Phone: 575-221-9303
  • Fax: 916-884-7907
Mailing address:
  • Phone: 575-221-9303
  • Fax: 916-884-7907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-81880
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: