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NPI Code Detail

MEDICARE: AARON T HADDOCK BCBA

MEDICARE: AARON T HADDOCK BCBA
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 Analyst3909TX

General Provider Information

NPI Number : 1629566567
Entity Type Code : Individual
Provider Name (Legal Business Name) : AARON T HADDOCK BCBA
Provider Business Mailing Address
First Line : 7423 MARBLE GLEN LN
Second Line :
City : HOUSTON
State : TX
Zip : 77095-1501
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12110 HUFFMEISTER RD
Second Line :
City : CYPRESS
State : TX
Zip : 77429-3254
Country : US
Telephone Number : 281-894-1423
Fax Number : 832-912-4475
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2018
Last Update Date : 05/21/2021

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