Provider Demographics
NPI:1366687253
Name:SALVATORE A BARBARO III MD PA
Entity Type:Organization
Organization Name:SALVATORE A BARBARO III MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SALVATORE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BARBARO
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:210-490-4600
Mailing Address - Street 1:PO BOX 1196
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78294-1196
Mailing Address - Country:US
Mailing Address - Phone:210-490-4600
Mailing Address - Fax:210-490-4651
Practice Address - Street 1:19016 STONE OAK PKWY
Practice Address - Street 2:STE 190
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3280
Practice Address - Country:US
Practice Address - Phone:210-490-4600
Practice Address - Fax:210-490-4651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-08
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7900174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122121006Medicaid
TX122121006Medicaid