Provider Demographics
NPI:1487404026
Name:CREER, DACARIUS K
Entity type:Individual
Prefix:
First Name:DACARIUS
Middle Name:K
Last Name:CREER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 JUSTIN RD
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-4822
Mailing Address - Country:US
Mailing Address - Phone:469-458-9021
Mailing Address - Fax:
Practice Address - Street 1:272 S COLLINS RD STE 200
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:TX
Practice Address - Zip Code:75182-4643
Practice Address - Country:US
Practice Address - Phone:469-458-9021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-24-327451106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician