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NPI Code Detail

MEDICARE: MARY GANIYU

MEDICARE: MARY GANIYU
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 : 1376486126
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY GANIYU
Provider Business Mailing Address
First Line : 24124 CINCO VILLAGE CENTER BLVD STE 200
Second Line :
City : KATY
State : TX
Zip : 77494-8389
Country : US
Telephone Number : 832-263-6593
Fax Number :
Provider Business Practice Location Address
First Line : 24124 CINCO VILLAGE CENTER BLVD STE 200
Second Line :
City : KATY
State : TX
Zip : 77494-8389
Country : US
Telephone Number : 832-263-6593
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2026
Last Update Date : 04/14/2026

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Directions to “ MARY GANIYU ” Practice Location

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