Provider Demographics
NPI:1669842316
Name:BAO, SHIMIN (MA, BCBA)
Entity type:Individual
Prefix:MRS
First Name:SHIMIN
Middle Name:
Last Name:BAO
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12930 DAIRY ASHFORD RD STE 802
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4667
Mailing Address - Country:US
Mailing Address - Phone:979-418-1551
Mailing Address - Fax:
Practice Address - Street 1:12930 DAIRY ASHFORD RD STE 802
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4667
Practice Address - Country:US
Practice Address - Phone:979-418-1551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-06
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst