Organization
MEBE TEXAS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ESTEBAN GONZALEZ (CONTRACTS/CREDENTIALING SPECIALIST)
(619) 323-0832
Entity
Organization
Contact information
Practice address
1401 LAVACA ST # 742, AUSTIN, TX 78701-1634
(619) 795-9925
Mailing address
8885 RIO SAN DIEGO DR STE 340, SAN DIEGO, CA 92108-1669
(619) 975-9925
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
05/27/2020
Last updated
07/02/2020
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