MEDICARE: ALEXIS OCTAVIA PAVLOFF

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	:	1932829272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIS OCTAVIA PAVLOFF

Provider Business Mailing Address
First Line	:	117 ILLINOIS RD
Second Line	:
City	:	DYESS AFB
State	:	TX
Zip	:	79607-1119
Country	:	US
Telephone Number	:	830-388-0187
Fax Number	:

Provider Business Practice Location Address
First Line	:	3444 N 1ST ST STE 508
Second Line	:
City	:	ABILENE
State	:	TX
Zip	:	79603-6941
Country	:	US
Telephone Number	:	325-268-4052
Fax Number	:

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

Provider Enumeration Date	:	08/29/2022
Last Update Date	:	05/12/2025

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Directions to “ ALEXIS OCTAVIA PAVLOFF ” Practice Location

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