Provider Demographics
NPI:1881916278
Name:PUGH, EUGENE JOHN (MA, BCBA)
Entity type:Individual
Prefix:MR
First Name:EUGENE
Middle Name:JOHN
Last Name:PUGH
Suffix:
Gender:M
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 1:2723 JEB STUART DR
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-4805
Mailing Address - Country:US
Mailing Address - Phone:417-499-1093
Mailing Address - Fax:
Practice Address - Street 1:2723 JEB STUART DR
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-4805
Practice Address - Country:US
Practice Address - Phone:417-499-1093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst