Provider Demographics
NPI:1346858271
Name:BARIUM SURGICAL PLLC
Entity Type:Organization
Organization Name:BARIUM SURGICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:BENAE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-908-3519
Mailing Address - Street 1:25 HIGHLAND PARK VLG STE 100-829
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-2789
Mailing Address - Country:US
Mailing Address - Phone:469-908-3519
Mailing Address - Fax:
Practice Address - Street 1:25 HIGHLAND PARK VLG STE 100-829
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-2789
Practice Address - Country:US
Practice Address - Phone:469-908-3519
Practice Address - Fax:205-729-5887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-16
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty