Provider Demographics
NPI:1770163628
Name:BARKER, PHIL J II (MD)
Entity type:Individual
Prefix:DR
First Name:PHIL
Middle Name:J
Last Name:BARKER
Suffix:II
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 1:1315 HARDING PL
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-3532
Mailing Address - Country:US
Mailing Address - Phone:832-317-2709
Mailing Address - Fax:
Practice Address - Street 1:6431 FANNIN ST STE JJL 2706
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1501
Practice Address - Country:US
Practice Address - Phone:713-500-0758
Practice Address - Fax:713-500-0758
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-13
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXU6682207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program