Provider Demographics
NPI:1053490854
Name:BARRIOS, OCTAVIO E (MD)
Entity Type:Individual
Prefix:DR
First Name:OCTAVIO
Middle Name:E
Last Name:BARRIOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 W GRAY ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-4476
Mailing Address - Country:US
Mailing Address - Phone:713-942-7546
Mailing Address - Fax:713-942-7544
Practice Address - Street 1:517 W GRAY ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77019-4476
Practice Address - Country:US
Practice Address - Phone:713-942-7546
Practice Address - Fax:713-942-7544
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4705207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX612952Medicare PIN
TXF67397Medicare UPIN