MEDICARE: LAUREN PAIGE GILMORE 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
1	103K00000X	Behavior Analyst	12044177	TX

General Provider Information

NPI Number	:	1629681226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN PAIGE GILMORE BCBA

Provider Business Mailing Address
First Line	:	3000 WESLAYAN ST STE 105
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027-5701
Country	:	US
Telephone Number	:	713-218-9947
Fax Number	:	713-218-8988

Provider Business Practice Location Address
First Line	:	3000 WESLAYAN ST STE 105
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027-5701
Country	:	US
Telephone Number	:	713-218-9947
Fax Number	:	713-218-8988

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

Provider Enumeration Date	:	08/25/2020
Last Update Date	:	08/25/2020

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Directions to “ LAUREN PAIGE GILMORE BCBA” Practice Location

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