Healthcare Provider Details

I. General information

NPI: 1295553675
Provider Name (Legal Business Name): AL-NAZISH JIWANI BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2024
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2909 E ARKANSAS LN STE C-101
ARLINGTON TX
76010-6941
US

IV. Provider business mailing address

2909 E ARKANSAS LN STE C-101
ARLINGTON TX
76010-6941
US

V. Phone/Fax

Practice location:
  • Phone: 469-596-8863
  • Fax: 817-549-6201
Mailing address:
  • Phone: 469-596-8863
  • Fax: 817-549-6201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number010934
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: