1508065624 NPI number — BARBARA PIKE, M.D., P.A.

Table of content: (NPI 1508065624)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508065624 NPI number — BARBARA PIKE, M.D., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BARBARA PIKE, 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:
1508065624
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/18/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
770 S HIGHWAY 377
Provider Second Line Business Mailing Address:
SUITE #208
Provider Business Mailing Address City Name:
PILOT POINT
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76258-4471
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
940-686-0550
Provider Business Mailing Address Fax Number:
940-686-0440

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
770 S HIGHWAY 377
Provider Second Line Business Practice Location Address:
SUITE #208
Provider Business Practice Location Address City Name:
PILOT POINT
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76258-4471
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
940-686-0550
Provider Business Practice Location Address Fax Number:
940-686-0440
Provider Enumeration Date:
07/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PIKE
Authorized Official First Name:
BARBARA
Authorized Official Middle Name:
HANKINSON
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
940-686-0550

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X , with the licence number:  J6664 , 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: 8776B9 . This is a "MEDICARE INDIVIDUAL PROVI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 10007838 . This is a "AMERIGROUP TPI NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: J6664 . This is a "LICENSE NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8G2732 . This is a "BLUE CROSS BLUE SHIELD PR" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1851376016 . This is a "INDIVIDUAL NPI NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 00186U . This is a "MEDICARE PTAN LEGACY GROU" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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