Provider Demographics
NPI:1649833351
Name:ALFONSO BARNARD BARRAGAN, MD PA
Entity type:Organization
Organization Name:ALFONSO BARNARD BARRAGAN, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFONSO
Authorized Official - Middle Name:BARNARD
Authorized Official - Last Name:BARRAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-789-2520
Mailing Address - Street 1:4903 19TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79407-2201
Mailing Address - Country:US
Mailing Address - Phone:806-789-2520
Mailing Address - Fax:
Practice Address - Street 1:215 OLD HIGHWAY 1187
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-0281
Practice Address - Country:US
Practice Address - Phone:817-993-4604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the HandGroup - Multi-Specialty