Healthcare Provider Details

I. General information

NPI: 1821872441
Provider Name (Legal Business Name): VIANCA ALCARAZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2023
Last Update Date: 08/23/2023
Certification Date: 08/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 N IH 35
AUSTIN TX
78705-1800
US

IV. Provider business mailing address

3104 E CAMELBACK RD STE 2969
PHOENIX AZ
85016-4502
US

V. Phone/Fax

Practice location:
  • Phone: 844-362-7943
  • Fax:
Mailing address:
  • Phone: 844-362-7943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: