Provider Demographics
NPI:1629137401
Name:VEAZEY, BARRY LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:LYNN
Last Name:VEAZEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2803 EARL RUDDER FWY S STE 103
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-6099
Mailing Address - Country:US
Mailing Address - Phone:979-731-8888
Mailing Address - Fax:979-731-8848
Practice Address - Street 1:2803 EARL RUDDER FWY S STE 103
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-6099
Practice Address - Country:US
Practice Address - Phone:979-731-8888
Practice Address - Fax:979-731-8848
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4765207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00410983OtherRAILROAD MEDICARE
TX130362006Medicaid
TX8U5903OtherBLUE CROSS CLUE SHIELD
TXE51610Medicare UPIN
TX130362006Medicaid