Basic Information
| Provider Information | |||||||||
| NPI: | 1093445447 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COLOMINA GARCIA | ||||||||
| FirstName: | PATRICIA | ||||||||
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| Credential: | BCBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10922 VISCONTI CT | ||||||||
| Address2: | |||||||||
| City: | RICHMOND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774064572 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3059867059 | ||||||||
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| Practice Location | |||||||||
| Address1: | 24124 CINCO VILLAGE CENTER BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | KATY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774948389 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8557827822 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2022 | ||||||||
| LastUpdateDate: | 07/18/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 5142 | TX | Y | Behavioral Health & Social Service Providers | Behavioral Analyst | 103K00000X | N | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.