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NPI Code Detail

MEDICARE: DAVID FONTANE BCBA

MEDICARE: DAVID FONTANE 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
1103K00000XBehavior Analyst1-24-76074TX

General Provider Information

NPI Number : 1225858640
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID FONTANE BCBA
Provider Business Mailing Address
First Line : 7500 SAN FELIPE ST STE 990
Second Line :
City : HOUSTON
State : TX
Zip : 77063-1708
Country : US
Telephone Number : 281-826-3382
Fax Number : 425-491-7683
Provider Business Practice Location Address
First Line : 5160 VILLAGE CREEK DR STE 2002
Second Line :
City : PLANO
State : TX
Zip : 75093-4498
Country : US
Telephone Number : 682-324-9376
Fax Number : 469-519-9103
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2024
Last Update Date : 02/03/2025

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