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General NPI Number Information
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NPI Number | 1609621523
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Entity Type | Individual
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Provider Name | JULIAN LANDROVE
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Gender | Male
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Dates
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Enumeration Date | 04/23/2024
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Last Update Date | 05/06/2024
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Provider Practice Location Address
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Address Line | 6200 SARATOGA BLVD
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City | CORPUS CHRISTI
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State | TX
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Zip | 78414-3421
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Country | US
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Telephone | 361-213-3652
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Fax |
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Provider Business Mailing Address
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Address Line | 310 EASY CIR # B
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City | CORPUS CHRISTI
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State | TX
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Zip | 78418-3177
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Country | US
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Telephone | 361-445-7740
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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 | 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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