MEDICARE: YISRAEL ELIAS DAHVID M.ED, BCBA, LBA

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	103K00000X	Behavior Analyst	1-19-38445	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1-19-38445	OTHER	TX	BACB

General Provider Information

NPI Number	:	1548811052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YISRAEL ELIAS DAHVID M.ED, BCBA, LBA

Provider Business Mailing Address
First Line	:	10401 S MASON RD STE 601&F602
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-5885
Country	:	US
Telephone Number	:	281-967-0218
Fax Number	:

Provider Business Practice Location Address
First Line	:	10401 S MASON RD STE 601&F602
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-5885
Country	:	US
Telephone Number	:	281-967-0218
Fax Number	:

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

Provider Enumeration Date	:	09/25/2019
Last Update Date	:	07/24/2025

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