Provider Demographics
NPI:1295919306
Name:DAVE JOSEPH BARRRIOS III MD APMC
Entity type:Organization
Organization Name:DAVE JOSEPH BARRRIOS III MD APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:BARRIOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-261-9004
Mailing Address - Street 1:200 BEAULLIEU DR
Mailing Address - Street 2:BLDG 3B
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-7230
Mailing Address - Country:US
Mailing Address - Phone:337-261-9004
Mailing Address - Fax:337-261-9002
Practice Address - Street 1:200 BEAULLIEU DR
Practice Address - Street 2:BLDG 3B
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-7230
Practice Address - Country:US
Practice Address - Phone:337-261-9004
Practice Address - Fax:337-261-9002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-26
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD023007208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1483001Medicaid
LA1483001Medicaid