Provider Demographics
NPI:1396718516
Name:VAN BAVEL, JULIUS HENRY (MD)
Entity type:Individual
Prefix:DR
First Name:JULIUS
Middle Name:HENRY
Last Name:VAN BAVEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JAY
Other - Middle Name:HENRY
Other - Last Name:VANBAVEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3410 FAR WEST BLVD
Mailing Address - Street 2:146
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-3194
Mailing Address - Country:US
Mailing Address - Phone:512-349-0777
Mailing Address - Fax:512-349-9111
Practice Address - Street 1:3410 FAR WEST BLVD
Practice Address - Street 2:146
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3194
Practice Address - Country:US
Practice Address - Phone:512-349-0777
Practice Address - Fax:512-349-9111
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG0228207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
84521JMedicare ID - Type Unspecified
B27233Medicare UPIN