Provider Demographics
NPI:1710239298
Name:SIMPSON, BARRY EUGENE (DC)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:EUGENE
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N HIGHWAY 377
Mailing Address - Street 2:SUITE E.
Mailing Address - City:ROANOKE
Mailing Address - State:TX
Mailing Address - Zip Code:76262-7100
Mailing Address - Country:US
Mailing Address - Phone:817-430-4624
Mailing Address - Fax:
Practice Address - Street 1:500 N HIGHWAY 377
Practice Address - Street 2:SUITE E.
Practice Address - City:ROANOKE
Practice Address - State:TX
Practice Address - Zip Code:76262-7100
Practice Address - Country:US
Practice Address - Phone:817-430-4624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-09
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10899111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor