Provider Demographics
NPI:1922757434
Name:BEHUNIN, MERCEDES M
Entity Type:Individual
Prefix:
First Name:MERCEDES
Middle Name:M
Last Name:BEHUNIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4406 TEALGATE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-8538
Mailing Address - Country:US
Mailing Address - Phone:970-620-6645
Mailing Address - Fax:
Practice Address - Street 1:440 HIGHWAY 59 LOOP S
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-9096
Practice Address - Country:US
Practice Address - Phone:936-328-8148
Practice Address - Fax:936-327-2491
Is Sole Proprietor?:No
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX217051224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant