Provider Demographics
NPI:1295144186
Name:JOHN BARNETT MD PA
Entity type:Organization
Organization Name:JOHN BARNETT MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SERNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-391-0130
Mailing Address - Street 1:2129 MARTIN DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-5995
Mailing Address - Country:US
Mailing Address - Phone:817-391-0130
Mailing Address - Fax:817-391-0136
Practice Address - Street 1:2129 MARTIN DR
Practice Address - Street 2:SUITE 200
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-5995
Practice Address - Country:US
Practice Address - Phone:817-391-0130
Practice Address - Fax:817-391-0136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-05
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD5910208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty