Provider Demographics
NPI:1972531200
Name:BARR, DAVID THURSTON (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:THURSTON
Last Name:BARR
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 1:229 PARKING WAY ST
Mailing Address - Street 2:
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-5226
Mailing Address - Country:US
Mailing Address - Phone:979-297-4066
Mailing Address - Fax:979-292-0504
Practice Address - Street 1:229 PARKING WAY ST
Practice Address - Street 2:
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-5226
Practice Address - Country:US
Practice Address - Phone:979-297-4066
Practice Address - Fax:979-292-0504
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3132207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX137126204Medicaid
TX137126204OtherTEXAS PROVIDER IDENTIFIER
TXC13199Medicare UPIN
TX137126204Medicaid