Provider Demographics
NPI:1013663509
Name:BARTON, DYLAN JOSEPH (ATC, LAT)
Entity Type:Individual
Prefix:
First Name:DYLAN
Middle Name:JOSEPH
Last Name:BARTON
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 COUNTY ROAD 322
Mailing Address - Street 2:
Mailing Address - City:SHINER
Mailing Address - State:TX
Mailing Address - Zip Code:77984-6131
Mailing Address - Country:US
Mailing Address - Phone:361-258-1764
Mailing Address - Fax:
Practice Address - Street 1:315 E GONZALES ST
Practice Address - Street 2:
Practice Address - City:YOAKUM
Practice Address - State:TX
Practice Address - Zip Code:77995-3307
Practice Address - Country:US
Practice Address - Phone:361-293-3036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT72082255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer