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NPI Code Detail

MEDICARE: DAMARA HAWKINS

MEDICARE: DAMARA HAWKINS
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 : 1265212229
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAMARA HAWKINS
Provider Business Mailing Address
First Line : 4143 GARDENDALE ST
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-3129
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4143 GARDENDALE ST
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-3129
Country : US
Telephone Number : 210-319-9807
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2023
Last Update Date : 10/05/2023

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Directions to “ DAMARA HAWKINS ” Practice Location

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