Basic Information
| Provider Information | |||||||||
| NPI: | 1851377626 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RABORN | ||||||||
| FirstName: | BARRY | ||||||||
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| Credential: | OP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7401 S. MAIN ST | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770304509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7137992300 | ||||||||
| FaxNumber: | 7137943380 | ||||||||
| Practice Location | |||||||||
| Address1: | 2525 W BELLFORT ST | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770545000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7133499335 | ||||||||
| FaxNumber: | 7133498433 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/22/2005 | ||||||||
| LastUpdateDate: | 12/09/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225000000X | 10065 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Orthotic Fitter |
No ID Information.