Provider Demographics
NPI:1619383643
Name:BOTELLO GARCIA, ALMA XOCHITL (MED, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:ALMA
Middle Name:XOCHITL
Last Name:BOTELLO GARCIA
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12708 LEE PARK LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78732-2365
Mailing Address - Country:US
Mailing Address - Phone:979-599-8295
Mailing Address - Fax:
Practice Address - Street 1:3006 BEE CAVES RD
Practice Address - Street 2:SUITE B-200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-5588
Practice Address - Country:US
Practice Address - Phone:512-328-5599
Practice Address - Fax:512-328-5585
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-10
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-14-16044103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst