Provider Demographics
NPI:1467470187
Name:BARNES, GARY LEE (FNP)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:LEE
Last Name:BARNES
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7668 ELDORADO PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-5753
Mailing Address - Country:US
Mailing Address - Phone:214-817-4425
Mailing Address - Fax:972-674-2788
Practice Address - Street 1:2504 RIDGE RD STE 207
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-2571
Practice Address - Country:US
Practice Address - Phone:214-817-4225
Practice Address - Fax:972-674-2788
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP112527363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX181937702Medicaid
TX652533OtherTSBNE
TX181937703Medicaid
TX037746822OtherFNP LICENSE
TX181937701Medicaid
TX8Y0320OtherBCBS
TX652533OtherTSBNE
TX181937702Medicaid
TX181937703Medicaid
TX8G6949Medicare PIN
TX8L12620Medicare PIN