Provider Demographics
NPI:1073996864
Name:DENNETT, BARBARA
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:DENNETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6829 AVENUE K
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074
Mailing Address - Country:US
Mailing Address - Phone:903-312-8049
Mailing Address - Fax:888-670-7733
Practice Address - Street 1:6829 K AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-2541
Practice Address - Country:US
Practice Address - Phone:972-422-8280
Practice Address - Fax:972-422-8315
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX461570237332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3313108-04Medicaid
TX1841536943Medicare NSC