Provider Demographics
NPI:1073859559
Name:BUCHIGNANI, BARRY PHILLIP (PTA)
Entity Type:Individual
Prefix:MR
First Name:BARRY
Middle Name:PHILLIP
Last Name:BUCHIGNANI
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1755 WITTINGTON PL STE 800
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-1931
Mailing Address - Country:US
Mailing Address - Phone:214-442-4537
Mailing Address - Fax:866-534-5697
Practice Address - Street 1:1755 WITTINGTON PL STE 800
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-1931
Practice Address - Country:US
Practice Address - Phone:214-442-4537
Practice Address - Fax:866-534-5697
Is Sole Proprietor?:No
Enumeration Date:2013-01-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYA02523225200000X
TN4880225200000X
TX2078290225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant