Tevin Daishawn Brantley
Individual provider Active NPI Behavior Technician · Trinity, TX
NPI 1548058993 · NPPES record last updated Apr 28, 2025
Key facts
- NPI
- 1548058993
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 445 Mill Pond Rd
Trinity, TX 75862-6008 - Phone
- (281) 505-4819
- NPI assigned
- Apr 28, 2025
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | TX | Yes |
Addresses
Primary practice location
445 Mill Pond Rd
Trinity, TX 75862-6008
Mailing address
445 Mill Pond Rd
Trinity, TX 75862-6008
Phone (281) 505-4819
Other providers in Trinity, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 28, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.