Provider Demographics
NPI:1013109503
Name:BARCH, JEFFREY MARK (RRT)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:MARK
Last Name:BARCH
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6305 SANDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76001-8114
Mailing Address - Country:US
Mailing Address - Phone:817-504-5923
Mailing Address - Fax:
Practice Address - Street 1:6305 SANDSTONE DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76001-8114
Practice Address - Country:US
Practice Address - Phone:817-504-5923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50457227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered