Provider Demographics
NPI:1023488707
Name:BARKER BARIATRIC CENTER
Entity type:Organization
Organization Name:BARKER BARIATRIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:N
Authorized Official - Last Name:NIEMIETZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-491-7090
Mailing Address - Street 1:12222 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 305
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-3755
Mailing Address - Country:US
Mailing Address - Phone:972-270-4800
Mailing Address - Fax:214-367-1153
Practice Address - Street 1:12222 N CENTRAL EXPY
Practice Address - Street 2:SUITE 305
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3755
Practice Address - Country:US
Practice Address - Phone:972-270-4800
Practice Address - Fax:214-367-1153
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR. WADE N. BARKER, P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-06
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ1859261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty