MEDICARE: STEPHANIE HRADIL

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-21-182640

General Provider Information

NPI Number	:	1427780352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE HRADIL

Provider Business Mailing Address
First Line	:	15934 OAK MOUNTAIN DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77095-3690
Country	:	US
Telephone Number	:	281-967-4423
Fax Number	:

Provider Business Practice Location Address
First Line	:	4899 HIGHWAY 6 STE 205B
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-3987
Country	:	US
Telephone Number	:	832-945-1445
Fax Number	:

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

Provider Enumeration Date	:	06/29/2022
Last Update Date	:	06/29/2022

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Directions to “ STEPHANIE HRADIL ” Practice Location

Language	Start Address	Practice Location

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