Basic Information
| Provider Information | |||||||||
| NPI: | 1043839384 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VILLALPANDO | ||||||||
| FirstName: | MEGAN | ||||||||
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| Credential: | BCBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4472 MATHER | ||||||||
| Address2: | |||||||||
| City: | KYLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786409289 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7657485765 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3006 BEE CAVES RD STE B200 | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787466751 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123285599 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/15/2020 | ||||||||
| LastUpdateDate: | 04/15/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 3336 | TX | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.