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NPI Code Detail

MEDICARE: ANTHONY RICHARD FLETCHER

MEDICARE: ANTHONY RICHARD FLETCHER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician15-02331TX

General Provider Information

NPI Number : 1093213456
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY RICHARD FLETCHER
Provider Business Mailing Address
First Line : 234 W BANDERA RD # 325
Second Line :
City : BOERNE
State : TX
Zip : 78006-2805
Country : US
Telephone Number : 225-505-8024
Fax Number :
Provider Business Practice Location Address
First Line : 2525 LADD ST
Second Line :
City : LACKLAND AFB
State : TX
Zip : 78236-5308
Country : US
Telephone Number : 210-447-7041
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2018
Last Update Date : 01/31/2018

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Directions to “ ANTHONY RICHARD FLETCHER ” Practice Location

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