=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104757798
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOSHUA RAFAEL BUNING
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/25/2026
-----------------------------------------------------
Last Update Date | 05/25/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3737 EXECUTIVE CENTER DR STE 255
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78731-1633
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 737-346-3334
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12304 SAVANNAH BROOKS LN
-----------------------------------------------------
City | MANOR
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78653-2239
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-993-5209
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------