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NPI Code Detail

MEDICARE: ANALISA OLDHAM BCBA

MEDICARE: ANALISA OLDHAM 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 Analyst

General Provider Information

NPI Number : 1710815691
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANALISA OLDHAM BCBA
Provider Business Mailing Address
First Line : 3052 S SHORE BLVD
Second Line :
City : LEAGUE CITY
State : TX
Zip : 77573-3907
Country : US
Telephone Number : 346-692-9627
Fax Number :
Provider Business Practice Location Address
First Line : 3052 S SHORE BLVD
Second Line :
City : LEAGUE CITY
State : TX
Zip : 77573-3907
Country : US
Telephone Number : 346-692-9627
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2026
Last Update Date : 05/12/2026

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Directions to “ ANALISA OLDHAM BCBA” Practice Location

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