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NPI Code Detail

MEDICARE: TEXOMA ABA, LLC

MEDICARE: TEXOMA ABA, LLC
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 Analyst

General Provider Information

NPI Number : 1396416889
Entity Type Code : Organization
Provider Name (Legal Business Name) : TEXOMA ABA, LLC
Provider Business Mailing Address
First Line : 2612 W LAMBERTH RD STE 100
Second Line :
City : SHERMAN
State : TX
Zip : 75092-5181
Country : US
Telephone Number : 808-720-7107
Fax Number : 903-200-1505
Provider Business Practice Location Address
First Line : 2612 W LAMBERTH RD STE 100
Second Line :
City : SHERMAN
State : TX
Zip : 75092-5181
Country : US
Telephone Number : 808-720-7107
Fax Number : 903-200-1505
Authorized Official
Title or Position : CEO
Name : SIERRA WHITTINGTON
Credential :
Telephone Number : 808-720-7107
Provider Enumeration Date : 09/23/2021
Last Update Date : 10/31/2024

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Directions to “TEXOMA ABA, LLC ” Practice Location

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