Provider Demographics
NPI:1750795639
Name:CURTIS, BARRY JOHN (OD)
Entity type:Individual
Prefix:
First Name:BARRY
Middle Name:JOHN
Last Name:CURTIS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15933 CLAYTON RD STE 210
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63011-2172
Mailing Address - Country:US
Mailing Address - Phone:636-200-4393
Mailing Address - Fax:800-972-5069
Practice Address - Street 1:1809 DATA DR
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-1238
Practice Address - Country:US
Practice Address - Phone:205-982-5000
Practice Address - Fax:205-982-5920
Is Sole Proprietor?:No
Enumeration Date:2014-06-18
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-D19-TA-C40152W00000X
TX8384TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1750795639OtherNPI
TX1234530001OtherDMERC
TX00E41YOtherGROUP PIN
TX752711435OtherGROUP TAX ID
TX84550QOtherBCBS
TX1902852346OtherGROUP NPI
TX8384TGOtherSTATE LICENSE
TXA0209229OtherDPS
TXA0209229OtherDPS
TX1234530001OtherDMERC
TX1750795639OtherNPI