Healthcare Provider Details

I. General information

NPI: 1497086144
Provider Name (Legal Business Name): STEPHEN L BARRETT DPM AUSTIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2010
Last Update Date: 03/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3107 OAK CREEK DR STE 120
AUSTIN TX
78727-3025
US

IV. Provider business mailing address

PO BOX 924587
HOUSTON TX
77292-4587
US

V. Phone/Fax

Practice location:
  • Phone: 512-244-7800
  • Fax: 512-244-7802
Mailing address:
  • Phone: 713-586-6705
  • Fax: 713-586-6752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number801185697
License Number StateTX

VIII. Authorized Official

Name: MS. LINDA KELLNER
Title or Position: DIRECTOR OF MEDICAL CREDENTIALING
Credential: DMC
Phone: 713-586-6705