Provider Demographics
NPI:1700880382
Name:WAY, BARBARA HAIGHT (MD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:HAIGHT
Last Name:WAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 41ST ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79413-3104
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4102 24TH ST
Practice Address - Street 2:STE 201
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1801
Practice Address - Country:US
Practice Address - Phone:806-797-1892
Practice Address - Fax:806-797-1102
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE0182174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC23236Medicare UPIN
TX00RE52Medicare ID - Type Unspecified