Provider Demographics
NPI:1184452401
Name:HASSAN, MAHFUZ (BCBA)
Entity type:Individual
Prefix:
First Name:MAHFUZ
Middle Name:
Last Name:HASSAN
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 WATTS PLANTATION DR APT 13102
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-5557
Mailing Address - Country:US
Mailing Address - Phone:832-873-4164
Mailing Address - Fax:
Practice Address - Street 1:2225 PHILLIPS RD.STE
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573
Practice Address - Country:US
Practice Address - Phone:832-873-4164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst