1528313418 NPI number — RENEE ABSHER BOARD CERTIFIED BEHA

Table of content: RENEE ABSHER BOARD CERTIFIED BEHA (NPI 1528313418)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528313418 NPI number — RENEE ABSHER BOARD CERTIFIED BEHA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ABSHER
Provider First Name:
RENEE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
BOARD CERTIFIED BEHA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ABSHER
Provider Other First Name:
RENEE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
BCBA-BEHAVIORAL HEAL
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1528313418
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/12/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
548 CR 414
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YOAKUM
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77995
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
979-743-5575
Provider Business Mailing Address Fax Number:
361-579-6913

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
506 S EAGLE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEIMAR
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78962-2902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
979-314-7229
Provider Business Practice Location Address Fax Number:
855-839-6442
Provider Enumeration Date:
07/17/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X , with the licence number:  1-12-11641 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103K00000X , with the licence number: 2374 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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