Active NPI
Barry Wilson Rath, PH.D.
- Clinical Neuropsychologist
- Tyler, TX
National Provider Identifier
1619044856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 23719
- Practice address
- 826 S Fleishel Ave
Tyler, TX 75701-2016 - Phone
- (903) 592-6779
- Fax
- (903) 592-7208
- NPI assigned
- Nov 30, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 23719 | TX | Primary |
Addresses
Primary practice location
826 S Fleishel Ave
Tyler, TX 75701-2016
Mailing address
826 S Fleishel Ave
Tyler, TX 75701-2016
Phone (903) 592-6779
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OP23719 | Other | TX | WORKER'S COMPENSATION |
| 0326126 01 | Medicaid | TX | |
| 110012100 | Other | TX | US DEPARTMENT OF LABOR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320364800000",
"number": "1619044856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "826 S FLEISHEL AVE",
"city": "TYLER",
"state": "TX",
"postal_code": "757012016",
"telephone_number": "903-592-6779",
"fax_number": "903-592-7208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "826 S FLEISHEL AVE",
"city": "TYLER",
"state": "TX",
"postal_code": "757012016",
"telephone_number": "903-592-6779",
"fax_number": "903-592-7208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RATH",
"first_name": "BARRY",
"middle_name": "WILSON",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-30",
"last_updated": "2011-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "TX",
"license": "23719",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WORKER'S COMPENSATION",
"identifier": "OP23719",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0326126 01",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US DEPARTMENT OF LABOR",
"identifier": "110012100",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.