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NPI Code Detail

MEDICARE: MR. JEFFREY BOOTS

MEDICARE: MR. JEFFREY BOOTS
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
1106E00000XAssistant Behavior Analyst

General Provider Information

NPI Number : 1124549704
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JEFFREY BOOTS
Provider Business Mailing Address
First Line : 7500 SAN FELIPE ST STE 999
Second Line :
City : HOUSTON
State : TX
Zip : 77063-1707
Country : US
Telephone Number : 281-826-3382
Fax Number : 425-491-7683
Provider Business Practice Location Address
First Line : 201 REGENCY PKWY
Second Line :
City : MANSFIELD
State : TX
Zip : 76063-5638
Country : US
Telephone Number : 682-400-0305
Fax Number : 682-334-7806
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/04/2017
Last Update Date : 05/30/2025

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