Provider Demographics
NPI:1477653962
Name:PIERCE, BARBARA LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:LEE
Last Name:PIERCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:LEE
Other - Last Name:MASSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1602 ROCK PRAIRIE RD
Mailing Address - Street 2:STE 1100
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-8306
Mailing Address - Country:US
Mailing Address - Phone:979-693-2586
Mailing Address - Fax:979-693-9047
Practice Address - Street 1:1602 ROCK PRAIRIE RD
Practice Address - Street 2:STE 1100
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-8306
Practice Address - Country:US
Practice Address - Phone:979-693-2586
Practice Address - Fax:979-693-9047
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3627207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO204641203Medicaid
119354OtherBLUE CROSS OF MO
G94645Medicare UPIN
080164731Medicare PIN
MOCC9890Medicare PIN
TXTXB101260Medicare PIN
932414635Medicare PIN