Provider Demographics
NPI:1477668192
Name:BARKER, BRADLEY J (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:J
Last Name:BARKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23501 CINCO RANCH BLVD STE B228
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-3278
Mailing Address - Country:US
Mailing Address - Phone:281-391-4200
Mailing Address - Fax:281-391-4203
Practice Address - Street 1:23501 CINCO RANCH BLVD STE B228
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-3278
Practice Address - Country:US
Practice Address - Phone:281-391-4200
Practice Address - Fax:281-391-4203
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX224421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice