1124208160 NPI number — MARK A. BARINQUE, DPM,PA

Table of content: (NPI 1124208160)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124208160 NPI number — MARK A. BARINQUE, DPM,PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARK A. BARINQUE, DPM,PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PLAINS PODIATRY ASSOCIATES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124208160
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/03/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 94161
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LUBBOCK
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79493-4161
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-793-6811
Provider Business Mailing Address Fax Number:
806-793-9278

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2204 ITHACA AVE
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
LUBBOCK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79410-1300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-793-6811
Provider Business Practice Location Address Fax Number:
806-793-9278
Provider Enumeration Date:
11/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BARINQUE
Authorized Official First Name:
MARK
Authorized Official Middle Name:
ANDREW
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
806-793-6811

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  1250 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 092825102 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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