Provider Demographics
NPI:1700416559
Name:MCCLURE, JONATHAN ALLAN (BCBA)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:ALLAN
Last Name:MCCLURE
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 1:5000 CAROLINE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-5704
Mailing Address - Country:US
Mailing Address - Phone:713-528-2343
Mailing Address - Fax:
Practice Address - Street 1:5000 CAROLINE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-5704
Practice Address - Country:US
Practice Address - Phone:713-528-2343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-21
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3217103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty