MEDICARE: TOMYRA ANDERSON

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1710817002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TOMYRA ANDERSON

Provider Business Mailing Address
First Line	:	12226 SCARLET RIVER DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77044-5350
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	19701 KINGWOOD DR STE 8
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77339-3775
Country	:	US
Telephone Number	:	281-973-0757
Fax Number	:

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

Provider Enumeration Date	:	05/20/2026
Last Update Date	:	05/20/2026

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Directions to “ TOMYRA ANDERSON ” Practice Location

Language	Start Address	Practice Location

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