MEDICARE: ALEXIS M HOLCOMB MA, 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
1	103K00000X	Behavior Analyst	1-23-68679	TX
2	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1790355196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIS M HOLCOMB MA, BCBA

Provider Business Mailing Address
First Line	:	9240 BELTWAY 8 STE 110
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77396-5141
Country	:	US
Telephone Number	:	832-412-1787
Fax Number	:

Provider Business Practice Location Address
First Line	:	9240 BELTWAY 8 STE 110
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77396-5141
Country	:	US
Telephone Number	:	832-412-1787
Fax Number	:

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

Provider Enumeration Date	:	06/28/2021
Last Update Date	:	10/05/2023

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