Provider Demographics
NPI:1154318855
Name:BARNES, WILLIAM ERNEST (DC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ERNEST
Last Name:BARNES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 LIVE OAK ST
Mailing Address - Street 2:
Mailing Address - City:COMMERCE
Mailing Address - State:TX
Mailing Address - Zip Code:75428-2460
Mailing Address - Country:US
Mailing Address - Phone:903-886-7040
Mailing Address - Fax:903-886-2964
Practice Address - Street 1:1910 LIVE OAK ST
Practice Address - Street 2:
Practice Address - City:COMMERCE
Practice Address - State:TX
Practice Address - Zip Code:75428-2460
Practice Address - Country:US
Practice Address - Phone:903-886-7040
Practice Address - Fax:903-886-2964
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-29
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2427111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0883423-01Medicaid
TX0883423-01Medicaid