Provider Demographics
NPI:1013028364
Name:BARR, VINCENT PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:PETER
Last Name:BARR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2707 BOLTON BOONE DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2076
Mailing Address - Country:US
Mailing Address - Phone:972-296-8885
Mailing Address - Fax:972-296-8935
Practice Address - Street 1:2707 BOLTON BOONE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2076
Practice Address - Country:US
Practice Address - Phone:972-296-8885
Practice Address - Fax:972-296-8935
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7972207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
C13197Medicare UPIN
TX00B80EMedicare ID - Type Unspecified