Provider Demographics
NPI:1083874952
Name:BAKIRIS, TSAMBIKA MICHAEL
Entity Type:Individual
Prefix:
First Name:TSAMBIKA
Middle Name:MICHAEL
Last Name:BAKIRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 202333
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78720-2333
Mailing Address - Country:US
Mailing Address - Phone:210-445-4880
Mailing Address - Fax:
Practice Address - Street 1:5550 HARVEST HILL RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1684
Practice Address - Country:US
Practice Address - Phone:210-445-4880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24871235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist