Healthcare Provider Details

I. General information

NPI: 1710842471
Provider Name (Legal Business Name): DILLON ANTHONY II
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2411 W SUNSET DR
ORANGE TX
77630-3211
US

IV. Provider business mailing address

2411 W SUNSET DR
ORANGE TX
77630-3211
US

V. Phone/Fax

Practice location:
  • Phone: 903-824-5556
  • Fax: 409-241-7263
Mailing address:
  • Phone: 903-824-5556
  • Fax: 409-241-7263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number9306
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: