=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780560607
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ELIZABETH BORGES BCBA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/14/2025
-----------------------------------------------------
Last Update Date | 08/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6300 BEE CAVES RD BLDG 2
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78746-5833
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-354-4300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 391 PERIDOT PASS
-----------------------------------------------------
City | MAXWELL
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78656-4413
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-766-3035
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number | 8802
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------