Provider Demographics
NPI:1710203633
Name:BARRERA, BRIEN (RPH)
Entity Type:Individual
Prefix:MR
First Name:BRIEN
Middle Name:
Last Name:BARRERA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 W LIGUSTRUM BLVD
Mailing Address - Street 2:
Mailing Address - City:ROBSTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78380-2525
Mailing Address - Country:US
Mailing Address - Phone:361-767-1595
Mailing Address - Fax:
Practice Address - Street 1:11158 LEOPARD ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78410-2612
Practice Address - Country:US
Practice Address - Phone:361-241-8639
Practice Address - Fax:361-241-5371
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-16
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38068183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist