Provider Demographics
NPI:1730332537
Name:BEHAVIOR & EDUCATION SPECIALISTS OF TEXAS
Entity type:Organization
Organization Name:BEHAVIOR & EDUCATION SPECIALISTS OF TEXAS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST, PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:REGAN
Authorized Official - Middle Name:ROTH
Authorized Official - Last Name:FITZGERALD
Authorized Official - Suffix:
Authorized Official - Credentials:MED, BCBA
Authorized Official - Phone:972-742-0807
Mailing Address - Street 1:505 LEXINGTON LN
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3350
Mailing Address - Country:US
Mailing Address - Phone:972-742-0807
Mailing Address - Fax:
Practice Address - Street 1:505 LEXINGTON LN
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3350
Practice Address - Country:US
Practice Address - Phone:972-742-0807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1041835103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty