Provider Demographics
NPI:1265102123
Name:MIDDLETON, BARBARA JEANETTE (CPHT)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:JEANETTE
Last Name:MIDDLETON
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:JEANETTE
Other - Last Name:SANFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPHT
Mailing Address - Street 1:800 N MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75110-3053
Mailing Address - Country:US
Mailing Address - Phone:903-874-1111
Mailing Address - Fax:
Practice Address - Street 1:800 N MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-3053
Practice Address - Country:US
Practice Address - Phone:903-874-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX128754183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician