MEDICARE: MARCUS GAVIN BEAN

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	BACB1415571	TX

General Provider Information

NPI Number	:	1801724703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCUS GAVIN BEAN

Provider Business Mailing Address
First Line	:	2901 BLEDSOE ST APT 2303
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76107-2827
Country	:	US
Telephone Number	:	505-249-0740
Fax Number	:

Provider Business Practice Location Address
First Line	:	7277 HAWKINS VIEW DR
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76132-3921
Country	:	US
Telephone Number	:	682-291-9911
Fax Number	:

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

Provider Enumeration Date	:	05/11/2026
Last Update Date	:	05/11/2026

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Directions to “ MARCUS GAVIN BEAN ” Practice Location

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