1861557647 NPI number — MARCUS D BARNETT M.D. P.A.

Table of content: (NPI 1861557647)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861557647 NPI number — MARCUS D BARNETT M.D. P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARCUS D BARNETT M.D. P.A.
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:
1861557647
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/17/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11307 FM 1960 W.
Provider Second Line Business Mailing Address:
#210 - CYFAIR MEDICAL PLAZA
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77065
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-807-0111
Provider Business Mailing Address Fax Number:
281-807-0114

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11307 F.M. 1960 W.
Provider Second Line Business Practice Location Address:
SUITE-210 - CYFAIR MEDICAL PLAZA
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77065
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-807-0111
Provider Business Practice Location Address Fax Number:
281-807-0114
Provider Enumeration Date:
12/22/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BARNETT
Authorized Official First Name:
MARCUS
Authorized Official Middle Name:
D.
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
281-807-0111

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  H9773 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208200000X , with the licence number: H9773 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: P000U94G2 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: P000U9452 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".