MEDICARE: TAHIRA SIRENA ALEXANDER RBT

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
1	106S00000X	Behavior Technician	BACB636199	TX

General Provider Information

NPI Number	:	1144002726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAHIRA SIRENA ALEXANDER RBT

Provider Business Mailing Address
First Line	:	6228 RIDGECREST RD APT 2401
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-6762
Country	:	US
Telephone Number	:	318-200-2401
Fax Number	:

Provider Business Practice Location Address
First Line	:	6814 LEBANON RD STE 101
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75034-7479
Country	:	US
Telephone Number	:	972-786-4316
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2023
Last Update Date	:	10/18/2023

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Directions to “ TAHIRA SIRENA ALEXANDER RBT” Practice Location

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