Provider Demographics
NPI:1497490395
Name:BARAKE, OSWALD COAMS (NP)
Entity Type:Individual
Prefix:
First Name:OSWALD
Middle Name:COAMS
Last Name:BARAKE
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3510 ASH GLEN DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-4538
Mailing Address - Country:US
Mailing Address - Phone:832-257-6098
Mailing Address - Fax:
Practice Address - Street 1:3510 ASH GLEN DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-4538
Practice Address - Country:US
Practice Address - Phone:832-257-6098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1075968363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care