Provider Demographics
NPI:1821554726
Name:TEXAS ABA & CHILD DEVELOPMENT SERVICES PLLC
Entity Type:Organization
Organization Name:TEXAS ABA & CHILD DEVELOPMENT SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED BEHAVIOR ANALYST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:FREEMAN-POTTER
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA
Authorized Official - Phone:214-853-3506
Mailing Address - Street 1:625 W CENTERVILLE RD STE 120
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-5428
Mailing Address - Country:US
Mailing Address - Phone:972-905-5257
Mailing Address - Fax:
Practice Address - Street 1:625 W CENTERVILLE RD STE 120
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-5428
Practice Address - Country:US
Practice Address - Phone:972-905-5257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-15
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive Care
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and SpeechGroup - Single Specialty
No252Y00000XAgenciesEarly Intervention Provider Agency