MEDICARE: ARIELLE BERMUDEZ

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	103K00000X	Behavior Analyst	1-23-69330	TX

General Provider Information

NPI Number	:	1144797200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIELLE BERMUDEZ

Provider Business Mailing Address
First Line	:	12527 CAMELLIA GLADE LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77044-1976
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9240 N SAM HOUSTON PKWY E STE 110
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77396-5141
Country	:	US
Telephone Number	:	855-782-7822
Fax Number	:

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

Provider Enumeration Date	:	10/26/2018
Last Update Date	:	11/02/2023

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Directions to “ ARIELLE BERMUDEZ ” Practice Location

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