Provider Demographics
NPI:1881226041
Name:CULL, BARBARA IRENE (LPTA)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:IRENE
Last Name:CULL
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 E 34TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78722-1921
Mailing Address - Country:US
Mailing Address - Phone:512-567-2009
Mailing Address - Fax:
Practice Address - Street 1:1501 E 34TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78722-1921
Practice Address - Country:US
Practice Address - Phone:512-567-2009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2--1559-0225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2-1559-0OtherTEXAS LPTA LICENSE