Provider Demographics
NPI:1740762459
Name:BARKER, BRANDI L (DC)
Entity Type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:L
Last Name:BARKER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MS
Other - First Name:BRANDI
Other - Middle Name:L
Other - Last Name:SELCHERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1012 TROWBRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-5254
Mailing Address - Country:US
Mailing Address - Phone:605-999-3170
Mailing Address - Fax:
Practice Address - Street 1:590 N. KIMBALL AVE
Practice Address - Street 2:SUITE 140
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092
Practice Address - Country:US
Practice Address - Phone:817-778-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-30
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4293111N00000X
TX14046111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor