Provider Demographics
NPI:1114931573
Name:BARKOCY, GARY ANDREW (DO)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:ANDREW
Last Name:BARKOCY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 RUSSELL BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-1248
Mailing Address - Country:US
Mailing Address - Phone:936-560-4327
Mailing Address - Fax:866-927-4221
Practice Address - Street 1:409 RUSSELL BLVD STE A
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-1248
Practice Address - Country:US
Practice Address - Phone:936-560-4327
Practice Address - Fax:866-927-4221
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2126207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145768102Medicaid
TX8R5784OtherBCBS
TXP00209257OtherRAILROAD MEDICARE
8D2717Medicare ID - Type Unspecified