Provider Demographics
NPI:1396902532
Name:BARNES, GERALD CORDELL (DC, CCSP)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:CORDELL
Last Name:BARNES
Suffix:
Gender:M
Credentials:DC, CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6060 N CENTRAL EXPY STE 229
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-5248
Mailing Address - Country:US
Mailing Address - Phone:469-759-0077
Mailing Address - Fax:
Practice Address - Street 1:6060 N CENTRAL EXPY STE 229
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-5248
Practice Address - Country:US
Practice Address - Phone:469-579-0077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-16
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10895111NS0005X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician