MEDICARE: MRS. ERIN DIXON RIVERA 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	1-17-26509	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1016	OTHER	TX	LICENSED BEHAVIOR ANALYST
2	1-17-26509	OTHER	TX	BCBA CERT ID

General Provider Information

NPI Number	:	1649790049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ERIN DIXON RIVERA M.ED., BCBA, LBA

Provider Business Mailing Address
First Line	:	8300 FM 1960 RD W STE 1000
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-5654
Country	:	US
Telephone Number	:	832-525-4742
Fax Number	:

Provider Business Practice Location Address
First Line	:	8300 FM 1960 RD W STE 1000
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-5654
Country	:	US
Telephone Number	:	832-525-4742
Fax Number	:

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

Provider Enumeration Date	:	06/27/2017
Last Update Date	:	07/19/2021

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