Provider Demographics
NPI:1760180954
Name:WENK, BARAK ANTHONY (MS)
Entity Type:Individual
Prefix:
First Name:BARAK
Middle Name:ANTHONY
Last Name:WENK
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 ELM ST
Mailing Address - Street 2:
Mailing Address - City:SANGER
Mailing Address - State:TX
Mailing Address - Zip Code:76266-9635
Mailing Address - Country:US
Mailing Address - Phone:940-458-7430
Mailing Address - Fax:
Practice Address - Street 1:815 W SHERMAN DR
Practice Address - Street 2:
Practice Address - City:AUBREY
Practice Address - State:TX
Practice Address - Zip Code:76227-4622
Practice Address - Country:US
Practice Address - Phone:940-668-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX119542235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist