Healthcare Provider Details

I. General information

NPI: 1265365308
Provider Name (Legal Business Name): IAN BARR
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8408 ANNALISE DR UNIT 155
AUSTIN TX
78744-5452
US

IV. Provider business mailing address

5101 SANGER AVE APT 701
WACO TX
76710-5869
US

V. Phone/Fax

Practice location:
  • Phone: 512-792-9501
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: