1598079287 NPI number — GASPAR Z BARCINAS MD INC

Table of content: (NPI 1598079287)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598079287 NPI number — GASPAR Z BARCINAS MD INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GASPAR Z BARCINAS MD INC
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:
GASPAR Z BARCINAS MD
Provider Other Organization Name Type Code:
5
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:
1598079287
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/05/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
103 DOCTORS DR
Provider Second Line Business Mailing Address:
PO BOX 160
Provider Business Mailing Address City Name:
BRIDGEPORT
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
26330-1720
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-842-5161
Provider Business Mailing Address Fax Number:
304-842-2280

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
103 DOCTORS DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRIDGEPORT
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26330-1720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-842-5161
Provider Business Practice Location Address Fax Number:
304-842-2280
Provider Enumeration Date:
08/05/2010

Additional Information

Authorized Official

Authorized Official Last Name:
BARCINAS
Authorized Official First Name:
GASPAR
Authorized Official Middle Name:
ZAMORAS
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
304-842-5161

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0127262000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com