Provider Demographics
NPI:1497285043
Name:BARGHASH, ELIAS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ELIAS
Middle Name:
Last Name:BARGHASH
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4242 MEDICAL DR STE 6300
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-5606
Mailing Address - Country:US
Mailing Address - Phone:210-614-8400
Mailing Address - Fax:210-614-8165
Practice Address - Street 1:2304 MARKETPLACE DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76711-2467
Practice Address - Country:US
Practice Address - Phone:254-202-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38027103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical