Provider Demographics
NPI:1770527624
Name:WILCOX, BARRY NEAL (MD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:NEAL
Last Name:WILCOX
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 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-437-9605
Practice Address - Street 1:3410 WORTH ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2003
Practice Address - Country:US
Practice Address - Phone:214-370-1400
Practice Address - Fax:214-370-1405
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4613207RX0202X, 2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX128917501Medicaid
TX128917503Medicaid
TX128917506Medicaid
TX8R1588OtherBLUE CROSS OF TEXAS
TX128917504Medicaid
TX128917502Medicaid
TX128917505Medicaid
TX128917505Medicaid
TX128917503Medicaid
TX8L13298Medicare PIN
TX88287KMedicare PIN
TX80944GMedicare PIN
TX8086M4Medicare PIN
TX8R1588OtherBLUE CROSS OF TEXAS