Healthcare Provider Details

I. General information

NPI: 1073196564
Provider Name (Legal Business Name): ARRUNN DELANEY JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2021
Last Update Date: 05/03/2021
Certification Date: 03/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18482 KUYKENDAHL RD STE 166
SPRING TX
77379-8123
US

IV. Provider business mailing address

22910 IMPERIAL VALLEY DR APT 510
HOUSTON TX
77073-1113
US

V. Phone/Fax

Practice location:
  • Phone: 877-712-2735
  • Fax:
Mailing address:
  • Phone: 281-912-5145
  • 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: