Provider Demographics
NPI:1265471981
Name:BARLOG, CHRISTINE FLORENCE (PT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:FLORENCE
Last Name:BARLOG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14615 SAN PEDRO STE 180
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-4311
Mailing Address - Country:US
Mailing Address - Phone:210-494-1102
Mailing Address - Fax:210-494-1226
Practice Address - Street 1:14615 SAN PEDRO STE 180
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-4311
Practice Address - Country:US
Practice Address - Phone:210-494-1102
Practice Address - Fax:210-494-1226
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1180043174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L19771Medicare PIN
TX00636YMedicare PIN
ILP00271847Medicare ID - Type UnspecifiedRAILROAD/MEDICARE