1487987541 NPI number — BARKER CYPRESS VISION, P.C.

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 1487987541 NPI number — BARKER CYPRESS VISION, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BARKER CYPRESS VISION, P.C.
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:
6
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:
1487987541
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/08/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9740 BARKER CYPRESS RD
Provider Second Line Business Mailing Address:
SUITE 112
Provider Business Mailing Address City Name:
CYPRESS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77433-1973
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-550-7900
Provider Business Mailing Address Fax Number:
281-550-7909

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9740 BARKER CYPRESS RD
Provider Second Line Business Practice Location Address:
SUITE 112
Provider Business Practice Location Address City Name:
CYPRESS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77433-1973
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-550-7900
Provider Business Practice Location Address Fax Number:
281-550-7909
Provider Enumeration Date:
09/08/2009

Additional Information

Authorized Official

Authorized Official Last Name:
PAYAN
Authorized Official First Name:
LORAINE
Authorized Official Middle Name:
RODRIGUEZ
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
281-550-7900

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  5501TG , 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: 1083792212 . This is a "NPI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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