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NPI Code Detail

MEDICARE: JESSICA KRYSTAL HANCOCK

MEDICARE: JESSICA KRYSTAL HANCOCK
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 : 1194650945
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA KRYSTAL HANCOCK
Provider Business Mailing Address
First Line : 4091 DILLY SHAW TAP RD
Second Line :
City : BRYAN
State : TX
Zip : 77808-7657
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9314 RYDER DR
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78254-2000
Country : US
Telephone Number : 979-402-6376
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2026
Last Update Date : 06/15/2026

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Directions to “ JESSICA KRYSTAL HANCOCK ” Practice Location

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