Healthcare Provider Details

I. General information

NPI: 1679463830
Provider Name (Legal Business Name): JENNIE GAIL ZAVALA RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2025
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10777 WESTHEIMER RD STE 1100
HOUSTON TX
77042-3462
US

IV. Provider business mailing address

688 W PARKTOWN DR
DEER PARK TX
77536-5734
US

V. Phone/Fax

Practice location:
  • Phone: 346-499-1217
  • Fax:
Mailing address:
  • Phone:
  • 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: