Provider Demographics
NPI:1356512610
Name:NOVAK, BARBRA J (PHD, CCC/A)
Entity type:Individual
Prefix:
First Name:BARBRA
Middle Name:J
Last Name:NOVAK
Suffix:
Gender:F
Credentials:PHD, CCC/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6701 FANNIN ST
Mailing Address - Street 2:MC.520
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2316
Mailing Address - Country:US
Mailing Address - Phone:832-822-3249
Mailing Address - Fax:832-825-4749
Practice Address - Street 1:6701 FANNIN ST
Practice Address - Street 2:MC.520
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2316
Practice Address - Country:US
Practice Address - Phone:832-822-3249
Practice Address - Fax:832-825-4749
Is Sole Proprietor?:No
Enumeration Date:2008-03-14
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51484231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K6275Medicare PIN