Healthcare Provider Details

I. General information

NPI: 1114333747
Provider Name (Legal Business Name): ARCHANA DHURKA MS, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2014
Last Update Date: 01/15/2021
Certification Date: 01/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5208 VILLAGE CREEK DR STE 104
PLANO TX
75093-4481
US

IV. Provider business mailing address

5208 VILLAGE CREEK DR STE 104
PLANO TX
75093-4481
US

V. Phone/Fax

Practice location:
  • Phone: 214-334-6659
  • Fax: 214-390-3469
Mailing address:
  • Phone: 214-334-6659
  • Fax: 214-390-3469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-14-16122
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: