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NPI Code Detail

MEDICARE: BILLY FELTON

MEDICARE:   BILLY  FELTON
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
1106S00000XBehavior Technician
2103K00000XBehavior Analyst6255TX

General Provider Information

NPI Number : 1871235499
Entity Type Code : Individual
Provider Name (Legal Business Name) : BILLY FELTON
Provider Business Mailing Address
First Line : 8885 RIO SAN DIEGO DR STE 340
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-1669
Country : US
Telephone Number : 619-795-9925
Fax Number : 877-602-5087
Provider Business Practice Location Address
First Line : 6319 CYPRESSWOOD DR STE 200
Second Line :
City : SPRING
State : TX
Zip : 77379
Country : US
Telephone Number : 281-798-0302
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2022
Last Update Date : 11/28/2023

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