Individual
JESHUA JORGE BARAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1301 W 38TH ST #102, AUSTIN, TX 78705-1010
(512) 454-4561
(512) 467-2906
Mailing address
PO BOX 26726, AUSTIN, TX 78755-0726
(512) 407-8686
(512) 421-4489
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA05222
TX
363AM0700X
Medical Physician Assistant
PA05222
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202264202
—
TX
Enumeration date
03/22/2007
Last updated
09/23/2010
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