Provider Demographics
NPI:1649484965
Name:BARKSDALE, STEPHEN WEBB (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:WEBB
Last Name:BARKSDALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2103 ADAMS DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-3202
Mailing Address - Country:US
Mailing Address - Phone:817-299-8070
Mailing Address - Fax:
Practice Address - Street 1:2103 ADAMS DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-3202
Practice Address - Country:US
Practice Address - Phone:817-299-8070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF73952084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX104315007Medicaid
104315006OtherMEDICAID CSHCN
TXC13164Medicare UPIN