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General NPI Number Information
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NPI Number | 1245042449
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Entity Type | Organization
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Legal Business Name | SPECTRUMONE SPORTS
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Dates
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Enumeration Date | 01/23/2025
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 404 CAMINO BAY DR
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City | KATY
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State | TX
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Zip | 77493-4655
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Country | US
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Telephone | 832-257-3850
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Fax |
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Provider Business Mailing Address
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Address Line | 404 CAMINO BAY DR
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City | KATY
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State | TX
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Zip | 77493-4655
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Country | US
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Telephone | 346-397-2980
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | XAVIEN JONES
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Credential |
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Telephone | 346-397-2980
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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