Individual provider Active NPI

Julie Diane Bates, PH.D.

  • Clinical Psychologist
  • Lubbock, TX
National Provider Identifier
1346313509
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
31057 Issued in TX
Practice address
5212 75TH St
Lubbock, TX 79424-2520
Phone
(806) 794-3393
Fax
(806) 794-3733
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 31057 TX Primary

Addresses

Primary practice location

5212 75TH St
Lubbock, TX 79424-2520

Mailing address

5212 75TH St
Lubbock, TX 79424-2520
Phone (806) 794-3393

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080804000322 TX Practitioner - Clinical Psychologist 1153495577

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
31057TXMDClinical Psychologist
31879TXMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lubbock Regional MHMR Center PastSince May 1, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346313509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5212 75TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794242520",
            "telephone_number": "806-794-3393",
            "fax_number": "806-794-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5212 75TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794242520",
            "telephone_number": "806-794-3393",
            "fax_number": "806-794-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATES",
        "first_name": "JULIE",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "31057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.