Provider Demographics
NPI:1033403480
Name:BARTEET, TOM (ATP)
Entity Type:Individual
Prefix:
First Name:TOM
Middle Name:
Last Name:BARTEET
Suffix:
Gender:M
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 OLD MINDEN RD
Mailing Address - Street 2:SUITE 17G
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-4800
Mailing Address - Country:US
Mailing Address - Phone:318-752-2273
Mailing Address - Fax:318-752-2275
Practice Address - Street 1:1701 OLD MINDEN RD
Practice Address - Street 2:SUITE 17G
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-4800
Practice Address - Country:US
Practice Address - Phone:318-752-2273
Practice Address - Fax:318-752-2275
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other