Provider Demographics
NPI:1255332409
Name:SCHRAGER, BARRY (DPM)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:
Last Name:SCHRAGER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:BARRY
Other - Middle Name:
Other - Last Name:SCHRAGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM, PA
Mailing Address - Street 1:8226 DOUGLAS AVE
Mailing Address - Street 2:#704
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-5943
Mailing Address - Country:US
Mailing Address - Phone:214-691-5231
Mailing Address - Fax:214-691-1090
Practice Address - Street 1:8226 DOUGLAS AVE
Practice Address - Street 2:#704
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-5943
Practice Address - Country:US
Practice Address - Phone:214-691-5231
Practice Address - Fax:214-691-1090
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-09
Last Update Date:2007-07-09
Deactivation Date:2006-03-23
Deactivation Code:
Reactivation Date:2006-03-28
Provider Licenses
StateLicense IDTaxonomies
TX0381213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00K731OtherBLUE CROSS BLUE SHIELD ID
TX4038572OtherAETNA PROVIDER ID
TX00418VMedicare ID - Type UnspecifiedPROVIDER ID
TX4038572OtherAETNA PROVIDER ID