MEDICARE: ZACH REISS 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	247200000X	Other Technician	RBT-19-74780
2	103K00000X	Behavior Analyst	4104	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RBT-19-74780	OTHER		BACB

General Provider Information

NPI Number	:	1184181554
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZACH REISS RBT

Provider Business Mailing Address
First Line	:	16800 DALLAS PKWY STE 200
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75248-1961
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1255 SW LOOP 410 STE 137
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78227-1667
Country	:	US
Telephone Number	:	210-670-8028
Fax Number	:

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

Provider Enumeration Date	:	02/21/2019
Last Update Date	:	12/26/2024

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Directions to “ ZACH REISS RBT” Practice Location

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