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NPI Code Detail

MEDICARE: JOVAN PHILLIPS BCBA, LBA

MEDICARE: JOVAN PHILLIPS BCBA, LBA
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
1103K00000XBehavior Analyst1898TX

General Provider Information

NPI Number : 1124421326
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOVAN PHILLIPS BCBA, LBA
Provider Business Mailing Address
First Line : 7050 LAKEVIEW HAVEN DR STE 100
Second Line :
City : HOUSTON
State : TX
Zip : 77095-2694
Country : US
Telephone Number : 346-946-5563
Fax Number : 346-946-5563
Provider Business Practice Location Address
First Line : 1301 CENTRAL EXPY S STE 230
Second Line :
City : ALLEN
State : TX
Zip : 75013-8122
Country : US
Telephone Number : 855-772-8847
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2014
Last Update Date : 01/05/2026

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