Provider Demographics
NPI:1700181328
Name:BARAJAS DE LA ROCHA, FRANCISCO JAVIER (MD)
Entity Type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:JAVIER
Last Name:BARAJAS DE LA ROCHA
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:PO BOX 9049
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-9049
Mailing Address - Country:US
Mailing Address - Phone:303-415-5816
Mailing Address - Fax:303-293-0625
Practice Address - Street 1:101 ERIE PKWY STE 201C
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516-4072
Practice Address - Country:US
Practice Address - Phone:303-415-5816
Practice Address - Fax:303-292-0625
Is Sole Proprietor?:No
Enumeration Date:2011-01-12
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ7012207R00000X
CODR0067617207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKP01422917OtherRR MEDICARE WAYNOKA FAMILY CLINIC
OK200492310BOtherMEDICAID OSU
OK200492310AMedicaid
OK299133ZJ83OtherMEDICARE PIN WAYNOKA FAMILY CLINIC
OK299133YKW9Medicare PIN
OKP01318495OtherRAILROAD MEDICARE