Provider Demographics
NPI:1225119787
Name:ROSSON, BARRY (MD, JD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:
Last Name:ROSSON
Suffix:
Gender:M
Credentials:MD, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8321 SUMMER PLACE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8220
Mailing Address - Country:US
Mailing Address - Phone:512-537-4880
Mailing Address - Fax:512-342-8534
Practice Address - Street 1:8321 SUMMER PLACE DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8220
Practice Address - Country:US
Practice Address - Phone:512-537-4880
Practice Address - Fax:512-342-8534
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD84172084F0202X, 2084P0800X, 2084P0804X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00324909Medicare ID - Type UnspecifiedMEDICARE RAILROAD
TXB26025Medicare UPIN
TX8B7449Medicare ID - Type Unspecified