Provider Demographics
NPI:1902863731
Name:BARTRA, HOMAR J (MD)
Entity Type:Individual
Prefix:
First Name:HOMAR
Middle Name:J
Last Name:BARTRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16811 SOUTHWEST FWY STE 300
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4728
Mailing Address - Country:US
Mailing Address - Phone:281-276-0836
Mailing Address - Fax:
Practice Address - Street 1:16811 SOUTHWEST FWY STE 300
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-4728
Practice Address - Country:US
Practice Address - Phone:281-276-0836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8905207R00000X, 208M00000X
AZ33432207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX036136205Medicaid
TX036136201Medicaid
TX036136207Medicaid
TX036136208Medicaid
TX036136202Medicaid
TX036136204Medicaid
TX036136206Medicaid
TX8W2434OtherBLUE CROSS/BLUE SHIELD OF TEXAS
TXTXB159374Medicare PIN
TXG10696Medicare UPIN
TX8L17868Medicare PIN
TX036136202Medicaid
TX8L17873Medicare PIN
TXTXB156154Medicare PIN
TX8W2434OtherBLUE CROSS/BLUE SHIELD OF TEXAS
TX036136204Medicaid
TX036136208Medicaid
TXP01140709Medicare PIN