Provider Demographics
NPI:1477690071
Name:BARRY SCHRAGER, DPM, P.A.
Entity Type:Organization
Organization Name:BARRY SCHRAGER, DPM, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFC MGR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:M
Authorized Official - Last Name:PERSELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-691-5231
Mailing Address - Street 1:P O BOX 25014
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-1014
Mailing Address - Country:US
Mailing Address - Phone:214-691-5231
Mailing Address - Fax:214-691-1090
Practice Address - Street 1:5459 LA SIERRA
Practice Address - Street 2:101
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230
Practice Address - Country:US
Practice Address - Phone:214-691-5231
Practice Address - Fax:214-691-1090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX0381213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AJ678OtherBLUE CROSS PIN
TX1621872-01Medicaid
TX018765014Medicaid
TX4038572OtherAETNA
TX0067QNOtherBLUE CROSS
TX0067QNOtherBLUE CROSS
TX1255332409Medicare PIN
TXDB1528Medicare PIN
TX1477690071Medicare PIN
TX4038572OtherAETNA
TXT15778Medicare UPIN
TX8AJ678OtherBLUE CROSS PIN
TXP0008977Medicare PIN