1518275320 NPI number — DR. BARBARA LOCKETT DAVIS PH.D.

Table of content: DR. BARBARA LOCKETT DAVIS PH.D. (NPI 1518275320)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518275320 NPI number — DR. BARBARA LOCKETT DAVIS PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DAVIS
Provider First Name:
BARBARA
Provider Middle Name:
LOCKETT
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518275320
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/15/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 UNIVERSITY STA STOP A1100
Provider Second Line Business Mailing Address:
CMA 2.200
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78712-0114
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-471-1929
Provider Business Mailing Address Fax Number:
512-471-2957

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2504 WHITIS AVE
Provider Second Line Business Practice Location Address:
CMA 2.220
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78712-1538
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-471-1929
Provider Business Practice Location Address Fax Number:
512-471-2957
Provider Enumeration Date:
09/15/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  14316 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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