Provider Demographics
NPI:1841584166
Name:BARR, ROBERT WESTON (MA, ATP)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:WESTON
Last Name:BARR
Suffix:
Gender:M
Credentials:MA, ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 CIRCLE WAY
Mailing Address - Street 2:SUITE C
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566
Mailing Address - Country:US
Mailing Address - Phone:512-202-1678
Mailing Address - Fax:
Practice Address - Street 1:127 CIRCLE WAY
Practice Address - Street 2:SUITE C
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566
Practice Address - Country:US
Practice Address - Phone:512-202-1678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-03
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX247200000X246Z00000X, 246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7401990001Medicare NSC