Fred Banuelos
Behavior Technician in Round Rock, TX. Individual provider (NPI-1).
NPI number1003671389
StatusActive
Last updated in NPPESFeb 16, 2024
Details
- NPI
- 1003671389
- Entity type
- Individual (NPI-1)
- Name
- Fred Banuelos
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 16, 2024
- Certification date
- Feb 15, 2024
- Last updated
- Feb 16, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | TX | Yes |
Practice location
1250 S A W Grimes BlvdRound Rock, TX 78664-2854
Phone 512-661-4387
Mailing address
2701 Breezy Point CvRound Rock, TX 78665-2590
Phone 512-299-8224
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