Provider Demographics
NPI:1538645239
Name:TINA BARBOUR PLLC
Entity Type:Organization
Organization Name:TINA BARBOUR PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GINGRICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-295-8675
Mailing Address - Street 1:PO BOX 2358
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-8169
Mailing Address - Country:US
Mailing Address - Phone:214-892-8222
Mailing Address - Fax:866-207-2534
Practice Address - Street 1:4510 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1650
Practice Address - Country:US
Practice Address - Phone:618-604-4021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-16
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1184803355OtherPERSONAL