Provider Demographics
NPI:1649405622
Name:BARE, ROBERT TAYLOR (BC-HIS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:TAYLOR
Last Name:BARE
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 SHUMAN BOULEVARD
Mailing Address - Street 2:SUITE 401
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8123
Mailing Address - Country:US
Mailing Address - Phone:630-303-5380
Mailing Address - Fax:630-303-5385
Practice Address - Street 1:2700 N. O'CONNOR
Practice Address - Street 2:SUITE 102B
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-5698
Practice Address - Country:US
Practice Address - Phone:972-252-9360
Practice Address - Fax:972-252-7516
Is Sole Proprietor?:No
Enumeration Date:2009-05-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10747237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist