Provider Demographics
NPI:1154315091
Name:WEINSTEIN, BARRY P (DPM)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:P
Last Name:WEINSTEIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4234 ELLA BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-4210
Mailing Address - Country:US
Mailing Address - Phone:713-680-1979
Mailing Address - Fax:713-680-1978
Practice Address - Street 1:4234 ELLA BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-4210
Practice Address - Country:US
Practice Address - Phone:713-680-1979
Practice Address - Fax:713-680-1978
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-07
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0905213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX112211101Medicaid
TXT16536Medicare UPIN
TX00FJ09Medicare ID - Type Unspecified
TX5160650001Medicare NSC