Healthcare Provider Details

I. General information

NPI: 1154608362
Provider Name (Legal Business Name): LINDSAY MARY MEIDA EVANS BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2011
Last Update Date: 11/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14110 CYPRESS CREEK BLVD
CYPRESS TX
77429-3214
US

IV. Provider business mailing address

14110 CYPRESS CREEK BLVD
CYPRESS TX
77429-3214
US

V. Phone/Fax

Practice location:
  • Phone: 281-894-1423
  • Fax: 281-894-1422
Mailing address:
  • Phone: 281-894-1423
  • Fax: 281-894-1422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-11-9516
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: