Provider Demographics
NPI:1952323024
Name:WILLENS, BARRY G (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:G
Last Name:WILLENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20185 US HIGHWAY 59
Mailing Address - Street 2:SUITE 72
Mailing Address - City:NEW CANEY
Mailing Address - State:TX
Mailing Address - Zip Code:77357-8358
Mailing Address - Country:US
Mailing Address - Phone:281-689-8144
Mailing Address - Fax:281-333-8904
Practice Address - Street 1:20185 US HIGHWAY 59
Practice Address - Street 2:SUITE 72
Practice Address - City:NEW CANEY
Practice Address - State:TX
Practice Address - Zip Code:77357-8358
Practice Address - Country:US
Practice Address - Phone:281-689-8144
Practice Address - Fax:281-399-8904
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG9676207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX111611301Medicaid
TXC23503Medicare UPIN
TX00JQ72Medicare ID - Type Unspecified