Provider Demographics
NPI:1376045914
Name:SILVA, FABIAN (MS, LBA, BCBA)
Entity Type:Individual
Prefix:MR
First Name:FABIAN
Middle Name:
Last Name:SILVA
Suffix:
Gender:M
Credentials:MS, LBA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 SHORELINE DR STE 151
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-0176
Mailing Address - Country:US
Mailing Address - Phone:214-778-1153
Mailing Address - Fax:
Practice Address - Street 1:2701 SHORELINE DR STE 151
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-0176
Practice Address - Country:US
Practice Address - Phone:855-782-7822
Practice Address - Fax:818-241-6853
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0-21-12329106E00000X
106S00000X
TX1-23-68106103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician