MEDICARE: FALLON CARTER

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	106S00000X	Behavior Technician	RBT-25-477913	TX

General Provider Information

NPI Number	:	1295690980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FALLON CARTER

Provider Business Mailing Address
First Line	:	3918 NACO PERRIN BLVD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78217-2588
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3918 NACO PERRIN BLVD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78217-2588
Country	:	US
Telephone Number	:	478-957-3500
Fax Number	:

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

Provider Enumeration Date	:	12/16/2025
Last Update Date	:	12/16/2025

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Directions to “ FALLON CARTER ” Practice Location

Language	Start Address	Practice Location

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