Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 9250 | TX |
NPI | 1114015195 |
---|---|
Provider Name | Dr. Micah Barber |
First Address | New Braunfels, TX 78130-7647 |
Second Address | New Braunfels, TX 78130-7647 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 22/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U94149 | (02) | TX |