1184611782 NPI number — JUAN CARLOS BARRIGA MD PA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184611782 NPI number — JUAN CARLOS BARRIGA MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JUAN CARLOS BARRIGA MD 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:
Provider Other Organization Name Type Code:
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:
1184611782
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/05/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
746 COLUMBIA ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77007-1635
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-426-5864
Provider Business Mailing Address Fax Number:
713-869-3716

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
720 W 11TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77008-6714
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-426-5864
Provider Business Practice Location Address Fax Number:
713-869-3716
Provider Enumeration Date:
09/29/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BARRIGA
Authorized Official First Name:
JUAN
Authorized Official Middle Name:
CARLOS
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
713-426-5864

Provider Taxonomy Codes

  • Taxonomy code: 207RC0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RP1001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 161138601 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: DA5797 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0032PY . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".