Provider Demographics
NPI:1972812113
Name:BARRON, JOSEPH MARK (PHD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MARK
Last Name:BARRON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11585 ALAMO RANCH PKWY APT 6207
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-6186
Mailing Address - Country:US
Mailing Address - Phone:727-458-1870
Mailing Address - Fax:
Practice Address - Street 1:11585 ALAMO RANCH PKWY APT 6207
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-6186
Practice Address - Country:US
Practice Address - Phone:727-458-1870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-06
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8171103T00000X
TX40068103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist