Provider Demographics
NPI:1689353351
Name:BARKER, JENNIFER DELORIS
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:DELORIS
Last Name:BARKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8300 DOUGLAS AVE STE 800
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-5826
Mailing Address - Country:US
Mailing Address - Phone:214-380-3485
Mailing Address - Fax:
Practice Address - Street 1:8300 DOUGLAS AVE STE 800
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-5826
Practice Address - Country:US
Practice Address - Phone:214-380-3485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator