1720674708 NPI number — DANIELLE B THOMAS BCBA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720674708 NPI number — DANIELLE B THOMAS BCBA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
THOMAS
Provider First Name:
DANIELLE
Provider Middle Name:
B
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
BCBA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BENOIT
Provider Other First Name:
DANIELLE
Provider Other Middle Name:
B
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LBA
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1720674708
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/18/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20914 AUTUMN REDWOOD WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CYPRESS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77433-5554
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
337-278-2149
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14135 HUFFMEISTER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CYPRESS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77429-1805
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-278-2149
Provider Business Practice Location Address Fax Number:
832-224-2863
Provider Enumeration Date:
12/14/2020

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:  5007 , 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: 1-20-45056 , 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)

  • Identifier: 5007 . This is a "TEXAS DEPARTMENT OF LICENSING AND REGULATION" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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