MEDICARE: MRS. REBECCA NICOLE BENDEKOVIC M.ED, 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
1	103K00000X	Behavior Analyst	3703	TX

General Provider Information

NPI Number	:	1144811514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. REBECCA NICOLE BENDEKOVIC M.ED, BCBA, LBA

Provider Business Mailing Address
First Line	:	4700 N CAPITAL OF TEXAS HWY APT 110
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78746-1132
Country	:	US
Telephone Number	:	772-607-0878
Fax Number	:

Provider Business Practice Location Address
First Line	:	3423 BEE CAVES RD
Second Line	:
City	:	WEST LAKE HILLS
State	:	TX
Zip	:	78746-7180
Country	:	US
Telephone Number	:	512-524-1374
Fax Number	:

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

Provider Enumeration Date	:	01/28/2021
Last Update Date	:	01/29/2021

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