Healthcare Provider Details

I. General information

NPI: 1164326773
Provider Name (Legal Business Name): IZABELLE B BARAJAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2720 W EULESS BLVD
EULESS TX
76040-6616
US

IV. Provider business mailing address

1710 N BECKLEY AVE APT 1161
DALLAS TX
75203-1158
US

V. Phone/Fax

Practice location:
  • Phone: 682-267-5956
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: