Basic Information
| Provider Information | |||||||||
| NPI: | 1134364409 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CONTEH | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | |||||||||
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| Credential: | BCBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7010 NW 100 DRIVE | ||||||||
| Address2: | #A104 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77092 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134626060 | ||||||||
| FaxNumber: | 7134626066 | ||||||||
| Practice Location | |||||||||
| Address1: | 7010 NW 100 DR STE A104 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770922052 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134626060 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/15/2008 | ||||||||
| LastUpdateDate: | 01/20/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 0-04-1385 | FL | N | Behavioral Health & Social Service Providers | Behavioral Analyst | 103K00000X | 1-09-6455 | TX | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.