Provider Demographics
NPI:1477281418
Name:MARZOUQ, HAMDAN (BCBA)
Entity type:Individual
Prefix:
First Name:HAMDAN
Middle Name:
Last Name:MARZOUQ
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 1:7801 MESQUITE BEND DR STE 105
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-6043
Mailing Address - Country:US
Mailing Address - Phone:972-756-9170
Mailing Address - Fax:214-614-4650
Practice Address - Street 1:7801 MESQUITE BEND DR STE 105
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-6043
Practice Address - Country:US
Practice Address - Phone:972-756-9170
Practice Address - Fax:214-614-4650
Is Sole Proprietor?:No
Enumeration Date:2022-08-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5237103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst