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NPI Code Detail

MEDICARE: MISTY GILBERT RBT

MEDICARE: MISTY GILBERT 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
1247200000XOther TechnicianRBT-17-31437TX
2103K00000XBehavior Analyst1-20-44948TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RBT-17-31437OTHERTXBACB

General Provider Information

NPI Number : 1225510894
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISTY GILBERT RBT
Provider Business Mailing Address
First Line : 3607 SOUTH LAMAR BLVD.
Second Line : APT. 1354
City : AUSTIN
State : TX
Zip : 78704-0391
Country : US
Telephone Number : 620-490-0262
Fax Number :
Provider Business Practice Location Address
First Line : 5307 AIRPORT BLVD STE C
Second Line :
City : AUSTIN
State : TX
Zip : 78751-2258
Country : US
Telephone Number : 512-561-1240
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2018
Last Update Date : 10/06/2020

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Directions to “ MISTY GILBERT RBT” Practice Location

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