Basic Information
| Provider Information | |||||||||
| NPI: | 1083008049 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TEXEIRA | ||||||||
| FirstName: | ALAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 819 | ||||||||
| Address2: | |||||||||
| City: | HONOKAA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967270819 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 65-1279 KAWAIHAE RD STE 201 | ||||||||
| Address2: | |||||||||
| City: | KAMUELA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967438444 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8088870747 | ||||||||
| FaxNumber: | 8088870741 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2015 | ||||||||
| LastUpdateDate: | 03/26/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.