Provider Demographics
NPI:1356320378
Name:BARSIK, TAMARA (MD)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:BARSIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1567
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-1567
Mailing Address - Country:US
Mailing Address - Phone:972-533-9893
Mailing Address - Fax:844-223-6484
Practice Address - Street 1:1832 CANYON CT
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-4742
Practice Address - Country:US
Practice Address - Phone:972-229-0664
Practice Address - Fax:214-227-7753
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5065207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX177129701Medicaid
G13237Medicare UPIN
8G1618Medicare PIN