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General NPI Number Information
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NPI Number | 1497508535
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Entity Type | Individual
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Provider Name | RYAN MATTHEW GOMES MA, BCBA
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Gender | Male
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Dates
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Enumeration Date | 04/09/2024
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Last Update Date | 04/09/2024
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Provider Practice Location Address
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Address Line | 23000 HIGHLAND KNOLLS BLVD
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City | KATY
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State | TX
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Zip | 77494-8341
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Country | US
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Telephone | 713-929-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 13131 FALLSVIEW LN APT 133
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City | HOUSTON
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State | TX
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Zip | 77077-3680
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Country | US
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Telephone | 410-259-1938
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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 | 1-24-72317
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License Number State | TX
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