=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609788223
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANTHONY MICHAEL PENLAND RBT
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/18/2026
-----------------------------------------------------
Last Update Date | 09/18/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2612 W LAMBERTH RD STE 100
-----------------------------------------------------
City | SHERMAN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75092-5181
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 254-249-6530
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1305 MILL ST UNIT B
-----------------------------------------------------
City | GAINESVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76240-3029
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 940-443-2422
-----------------------------------------------------
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 | RBT-26-2836607
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------