Provider Demographics
NPI:1083003305
Name:BARNES, JASON ANDREW (ATC, LAT)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:ANDREW
Last Name:BARNES
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6401 PARKWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-7239
Mailing Address - Country:US
Mailing Address - Phone:469-633-5576
Mailing Address - Fax:
Practice Address - Street 1:6401 PARKWOOD BLVD
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-7239
Practice Address - Country:US
Practice Address - Phone:469-633-5576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2039AT2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer