Provider Demographics
NPI:1427387596
Name:STEPHEN L BARRETT DPM DFW
Entity Type:Organization
Organization Name:STEPHEN L BARRETT DPM DFW
Other - Org Name:BARRETT FOOT & ANKLE CENTERS, DFW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF MEDICAL CREDENTIALING
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:KELLNER
Authorized Official - Suffix:
Authorized Official - Credentials:DMC
Authorized Official - Phone:713-586-6705
Mailing Address - Street 1:PO BOX 924587
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77292-4587
Mailing Address - Country:US
Mailing Address - Phone:713-586-6705
Mailing Address - Fax:713-586-6752
Practice Address - Street 1:1605 AIRPORT FREEWAY
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021
Practice Address - Country:US
Practice Address - Phone:817-267-4100
Practice Address - Fax:817-267-4101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty