MEDICARE: EITA PAEMANUULA IRENE MAY FALETAU MS, BCBA

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		TX

General Provider Information

NPI Number	:	1215872064
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EITA PAEMANUULA IRENE MAY FALETAU MS, BCBA

Provider Business Mailing Address
First Line	:	1679 SOTOGRANDE BLVD APT 101
Second Line	:
City	:	HURST
State	:	TX
Zip	:	76053-2670
Country	:	US
Telephone Number	:	682-240-1665
Fax Number	:

Provider Business Practice Location Address
First Line	:	4300 CITY POINT DR STE 101
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-8380
Country	:	US
Telephone Number	:	945-288-5781
Fax Number	:

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

Provider Enumeration Date	:	04/20/2026
Last Update Date	:	04/20/2026

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