Provider Demographics
NPI:1356020549
Name:BARRETT, MICHAEL
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:BARRETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UT HEALTH SCIENCE CENTER AT SAN ANTONIO
Mailing Address - Street 2:8210 FLOYD CURL DRIVE, MSC 8103
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3923
Mailing Address - Country:US
Mailing Address - Phone:210-450-3273
Mailing Address - Fax:210-450-3923
Practice Address - Street 1:UT HEALTH SCIENCE CENTER AT SAN ANTONIO
Practice Address - Street 2:8210 FLOYD CURL DRIVE, MSC 8103
Practice Address - City:SAN ANTONIO
Practice Address - State:VA
Practice Address - Zip Code:78229-3923
Practice Address - Country:US
Practice Address - Phone:210-450-3273
Practice Address - Fax:210-450-2223
Is Sole Proprietor?:No
Enumeration Date:2023-07-14
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXETN10641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice