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General NPI Number Information
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NPI Number | 1033673710
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Entity Type | Individual
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Provider Name | BRANDI BALCOM
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Gender | Female
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Dates
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Enumeration Date | 01/26/2019
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Last Update Date | 02/19/2026
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Provider Practice Location Address
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Address Line | 919 MEDICAL DR
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City | ALLEN
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State | TX
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Zip | 75013-5755
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Country | US
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Telephone | 469-795-7625
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Fax |
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Provider Business Mailing Address
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Address Line | 5111 WHISPER DR
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City | PARKER
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State | TX
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Zip | 75002-3151
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Country | US
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Telephone | 903-235-4686
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-18-33856
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License Number State | TX
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