Provider Demographics
NPI:1790807733
Name:BARRAZA, DAVID A (ST)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:A
Last Name:BARRAZA
Suffix:
Gender:M
Credentials:ST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3395 N CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-2306
Mailing Address - Country:US
Mailing Address - Phone:520-327-9677
Mailing Address - Fax:520-327-9678
Practice Address - Street 1:3395 N CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-2306
Practice Address - Country:US
Practice Address - Phone:520-327-9677
Practice Address - Fax:520-327-9678
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist