MEDICARE: MISS CORLETTE DYOUTH CROSS

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	CS-2227	TX

General Provider Information

NPI Number	:	1568602514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS CORLETTE DYOUTH CROSS

Provider Business Mailing Address
First Line	:	7903 COBBLEFIELD LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77071-2031
Country	:	US
Telephone Number	:	832-352-6340
Fax Number	:

Provider Business Practice Location Address
First Line	:	7903 COBBLEFIELD LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77071-2031
Country	:	US
Telephone Number	:	832-352-6340
Fax Number	:

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

Provider Enumeration Date	:	03/04/2009
Last Update Date	:	05/11/2026

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Directions to “ MISS CORLETTE DYOUTH CROSS ” Practice Location

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