Provider Demographics
NPI:1184053258
Name:YARBROUGH, RAYMOND (ATP)
Entity type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:
Last Name:YARBROUGH
Suffix:
Gender:M
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8217 SUMMER SIDE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8315
Mailing Address - Country:US
Mailing Address - Phone:512-845-8389
Mailing Address - Fax:
Practice Address - Street 1:11110 METRIC BLVD STE A
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-4097
Practice Address - Country:US
Practice Address - Phone:512-663-7477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-08
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXATP 52501225CA2400X
247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
No225CA2400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorAssistive Technology Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXATP 52501OtherRESNA