Healthcare Provider Details

I. General information

NPI: 1477262244
Provider Name (Legal Business Name): BIZAAN HOLDINGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2022
Last Update Date: 03/31/2023
Certification Date: 03/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2851 JOE DIMAGGIO BLVD STE 3
ROUND ROCK TX
78665-3928
US

IV. Provider business mailing address

2851 JOE DIMAGGIO BLVD STE 3
ROUND ROCK TX
78665-3928
US

V. Phone/Fax

Practice location:
  • Phone: 737-667-5680
  • Fax: 737-910-1362
Mailing address:
  • Phone: 737-667-5680
  • Fax: 737-910-1362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: KYLE ALLAN MCCALL
Title or Position: PRESIDENT & CEO
Credential: MA, LPC, LCDC, NCC
Phone: 512-423-1808