Provider Demographics
NPI:1639331473
Name:TRACHTENBERG, BARRY (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:
Last Name:TRACHTENBERG
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 1:6400 FANNIN ST STE 3000
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1527
Mailing Address - Country:US
Mailing Address - Phone:713-790-0841
Mailing Address - Fax:713-790-1350
Practice Address - Street 1:5115 FANNIN ST STE 801
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-5870
Practice Address - Country:US
Practice Address - Phone:713-790-0841
Practice Address - Fax:713-790-9663
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM7700207RC0000X, 207RA0001X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX305709305Medicaid
TX305709301Medicaid
TXP01309357OtherRR MEDICARE
TXP01098539OtherRR MEDICARE
TX305709603Medicaid
TXP01098539OtherRR MEDICARE
TX340073YMVQMedicare PIN