Healthcare Provider Details

I. General information

NPI: 1902728983
Provider Name (Legal Business Name): BROOKE HERSCHBACH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 S LARIAT CIR
DRIPPING SPRINGS TX
78620-2742
US

IV. Provider business mailing address

400 TOBIN DR
BUDA TX
78610-3737
US

V. Phone/Fax

Practice location:
  • Phone: 512-962-5543
  • Fax:
Mailing address:
  • Phone: 361-944-9451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBHV-010340
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: