Provider Demographics
NPI:1922377126
Name:SACCO BARKER HOLDINGS LLC
Entity Type:Organization
Organization Name:SACCO BARKER HOLDINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:F
Authorized Official - Last Name:SACCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:979-245-5721
Mailing Address - Street 1:1120 AVENUE G
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77414-3541
Mailing Address - Country:US
Mailing Address - Phone:979-245-5721
Mailing Address - Fax:979-245-1482
Practice Address - Street 1:3317 AVENUE F
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:TX
Practice Address - Zip Code:77414-7107
Practice Address - Country:US
Practice Address - Phone:979-323-9677
Practice Address - Fax:979-323-9960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care