Provider Demographics
NPI:1134337413
Name:DRISKILL AND BATES PSYCHOLOGY PA
Entity type:Organization
Organization Name:DRISKILL AND BATES PSYCHOLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:806-794-3393
Mailing Address - Street 1:5212 75TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-2520
Mailing Address - Country:US
Mailing Address - Phone:806-794-3393
Mailing Address - Fax:806-794-3733
Practice Address - Street 1:5212 75TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-2520
Practice Address - Country:US
Practice Address - Phone:806-794-3393
Practice Address - Fax:806-794-3733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31057103TC0700X
TX25028103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXR58756Medicare UPIN
TX00156PMedicare ID - Type UnspecifiedBATES MEDICARE
TNP25609Medicare UPIN