Provider Demographics
NPI:1376501932
Name:FLANDERS, BARRY N (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:N
Last Name:FLANDERS
Suffix:
Gender:M
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 2887
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77643-2887
Mailing Address - Country:US
Mailing Address - Phone:866-808-1556
Mailing Address - Fax:409-724-0214
Practice Address - Street 1:1025 GARNER FIELD RD
Practice Address - Street 2:
Practice Address - City:UVALDE
Practice Address - State:TX
Practice Address - Zip Code:78801
Practice Address - Country:US
Practice Address - Phone:830-278-6521
Practice Address - Fax:830-278-8529
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG75152085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX126403801Medicaid
TX126403806Medicaid
TX00F06ROtherBCBS
TXP00995414OtherRAILROAD
TX00F06ROtherBCBS
TXP00995414OtherRAILROAD
TX00F06RMedicare PIN