Provider Demographics
NPI:1972651313
Name:BARTON-NIELSEN, KAREN MICHELLE (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:MICHELLE
Last Name:BARTON-NIELSEN
Suffix:
Gender:F
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:PO BOX 846098
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-6098
Mailing Address - Country:US
Mailing Address - Phone:903-324-6450
Mailing Address - Fax:
Practice Address - Street 1:601 HWY 110 N BAY 0
Practice Address - Street 2:
Practice Address - City:WHITEHOUSE
Practice Address - State:TX
Practice Address - Zip Code:75791-3037
Practice Address - Country:US
Practice Address - Phone:903-839-2585
Practice Address - Fax:903-839-3165
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6034207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX047364704Medicaid
TX047364702Medicaid
TXTIN PLUS 001OtherTRICARE CANTON LOCATION
TX8BC403OtherBCBS OF TEXAS
TXTIN PLUS 023OtherTRICARE WHITHOUSE LOCATION
TXTIN PLUS 028OtherTRICARE LINDALE LOCATION
TXTIN PLUS 042OtherTRICARE WOUND CARE LOCATION
TX8B9735OtherBCBS
TXTIN PLUS 001OtherTRICARE CANTON LOCATION
TX047364702Medicaid
TX8B9735OtherBCBS