Provider Demographics
NPI:1811003767
Name:BARNETT, THOMAS M (NP-C)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:M
Last Name:BARNETT
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:JACK
Other - Middle Name:T
Other - Last Name:BARNETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP-C
Mailing Address - Street 1:9402 MESA DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77028-1201
Mailing Address - Country:US
Mailing Address - Phone:713-633-1626
Mailing Address - Fax:713-635-6253
Practice Address - Street 1:9402 MESA DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77028-1201
Practice Address - Country:US
Practice Address - Phone:713-633-1626
Practice Address - Fax:713-635-6253
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5661111N00000X
TX774906363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX856N17OtherBCBS