Provider Demographics
NPI:1902918675
Name:MILLS, BARRY JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:JOSEPH
Last Name:MILLS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 S OAKRIDGE DR STE 101-601
Mailing Address - Street 2:
Mailing Address - City:HUDSON OAKS
Mailing Address - State:TX
Mailing Address - Zip Code:76087-1794
Mailing Address - Country:US
Mailing Address - Phone:817-779-4466
Mailing Address - Fax:817-730-9110
Practice Address - Street 1:1332 DE LA VINA ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-3121
Practice Address - Country:US
Practice Address - Phone:805-681-0035
Practice Address - Fax:805-681-0029
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ01312084P0800X
MA2216072084P0800X
CAC511712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX124990608Medicaid
TX124990609Medicaid
TX124990609Medicaid
TX335610YKYMMedicare PIN
TX335610YRLZMedicare PIN