MEDICARE: ANGELA FAYE WARR AMS

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	CAMS-S	TX

General Provider Information

NPI Number	:	1740673847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA FAYE WARR AMS

Provider Business Mailing Address
First Line	:	PO BOX 700874
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75370-0874
Country	:	US
Telephone Number	:	972-741-3760
Fax Number	:

Provider Business Practice Location Address
First Line	:	4524 LEE ST
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75010-4157
Country	:	US
Telephone Number	:	972-741-3760
Fax Number	:

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

Provider Enumeration Date	:	03/13/2015
Last Update Date	:	06/05/2015

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