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NPI Code Detail

MEDICARE: TERRALINE GREEN

MEDICARE:   TERRALINE  GREEN
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1154252328
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERRALINE GREEN
Provider Business Mailing Address
First Line : 6914 BRISBANE CT STE 200
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-4924
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6914 BRISBANE CT STE 200
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-4924
Country : US
Telephone Number : 844-272-7223
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2026
Last Update Date : 05/27/2026

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Directions to “ TERRALINE GREEN ” Practice Location

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