Healthcare Provider Details

I. General information

NPI: 1023922051
Provider Name (Legal Business Name): BRENDAN WARD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1824 SAWDUST RD
SPRING TX
77380-3667
US

IV. Provider business mailing address

6222 W IH 10 STE 104
SAN ANTONIO TX
78201-2013
US

V. Phone/Fax

Practice location:
  • Phone: 210-447-0039
  • Fax:
Mailing address:
  • Phone: 210-447-0039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: