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NPI Code Detail

MEDICARE: MORGAN STOCKDALE M.ED., BCBA

MEDICARE: MORGAN STOCKDALE M.ED., 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 Analyst1-09-6329TX

General Provider Information

NPI Number : 1710296850
Entity Type Code : Individual
Provider Name (Legal Business Name) : MORGAN STOCKDALE M.ED., BCBA
Provider Business Mailing Address
First Line : 3006 BEE CAVE RD STE B200
Second Line :
City : AUSTIN
State : TX
Zip : 78746-6751
Country : US
Telephone Number : 512-328-5599
Fax Number :
Provider Business Practice Location Address
First Line : 3006 BEE CAVE RD STE B200
Second Line :
City : AUSTIN
State : TX
Zip : 78746-6751
Country : US
Telephone Number : 512-328-5599
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2010
Last Update Date : 10/06/2010

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