Provider Demographics
NPI:1659361194
Name:BARNHARDT, MARK ALAN (DO)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:ALAN
Last Name:BARNHARDT
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:3100 SCHOFIELD RD
Mailing Address - Street 2:BLDG 1179
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78234-7577
Mailing Address - Country:US
Mailing Address - Phone:210-916-3160
Mailing Address - Fax:210-808-2345
Practice Address - Street 1:3551 ROGER BROOKE DR
Practice Address - Street 2:DEPARTMENT OF PEDIATRICS/ADOLESCENT MEDICINE
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:210-916-3160
Practice Address - Fax:210-808-2345
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2011-09-12
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Provider Licenses
StateLicense IDTaxonomies
TXL2127208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics