Provider Demographics
NPI:1659759819
Name:BARNEY, SHANE (MD)
Entity type:Individual
Prefix:
First Name:SHANE
Middle Name:
Last Name:BARNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2833 BABCOCK ROAD
Mailing Address - Street 2:STE 212
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4894
Mailing Address - Country:US
Mailing Address - Phone:210-267-1709
Mailing Address - Fax:210-494-2439
Practice Address - Street 1:2833 BABCOCK ROAD
Practice Address - Street 2:STE 212
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4894
Practice Address - Country:US
Practice Address - Phone:210-267-1709
Practice Address - Fax:210-494-2439
Is Sole Proprietor?:No
Enumeration Date:2015-05-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXS5839208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1Q6365OtherPTAN
TX4245151-02Medicaid