Provider Demographics
NPI:1134780620
Name:BARRIENTOS, RICARDO (MD)
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:
Last Name:BARRIENTOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RICARDO
Other - Middle Name:
Other - Last Name:BARRIENTOS MUNOZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:279 BLUEGRASS DR
Mailing Address - Street 2:
Mailing Address - City:CULVER
Mailing Address - State:OR
Mailing Address - Zip Code:97734-7004
Mailing Address - Country:US
Mailing Address - Phone:832-612-1690
Mailing Address - Fax:
Practice Address - Street 1:55 NW WALL ST STE 160
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-3200
Practice Address - Country:US
Practice Address - Phone:832-612-1690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU1640208000000X
ORMD209687208000000X
TXBP10067562390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program