Provider Demographics
NPI:1952301384
Name:BARIBEAU, ALAN DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:DAVID
Last Name:BARIBEAU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7830 LOUIS PASTEUR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3404
Mailing Address - Country:US
Mailing Address - Phone:210-692-8888
Mailing Address - Fax:210-692-0764
Practice Address - Street 1:7830 LOUIS PASTEUR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3404
Practice Address - Country:US
Practice Address - Phone:210-692-8888
Practice Address - Fax:210-692-0764
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXD9352207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX079671601Medicaid
TX85720GOtherBLUE CROSS BLUE SHIELD
TX00046KOtherMEDICARE PROVIDER ID
TX85720GOtherBLUE CROSS BLUE SHIELD