Healthcare Provider Details

I. General information

NPI: 1144021528
Provider Name (Legal Business Name): ALYANNA OCAMPO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2025
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3552 FM 1092 RD
MISSOURI CITY TX
77459-2203
US

IV. Provider business mailing address

13202 QUIET LAKE LN
PEARLAND TX
77584-5580
US

V. Phone/Fax

Practice location:
  • Phone: 817-984-8655
  • Fax:
Mailing address:
  • Phone: 832-418-6472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberRBT-24-369558
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: