Provider Demographics
NPI:1831193465
Name:BARRETO, JOSE JAVIER (DPM)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:JAVIER
Last Name:BARRETO
Suffix:
Gender:M
Credentials:DPM
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 130937
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77219-0937
Mailing Address - Country:US
Mailing Address - Phone:713-533-0840
Mailing Address - Fax:713-533-0871
Practice Address - Street 1:114 W DREW ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-2002
Practice Address - Country:US
Practice Address - Phone:713-533-0840
Practice Address - Fax:713-533-0871
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-10
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1557213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1164677753OtherMEDICARE NPI
TX147207810Medicaid
TX0020JWOtherBLUE CROSS/BLUE SHIELDS
TX0A0251OtherMEDICARE PTAN
TX0A0250OtherMEDICARE PTAN
TX147207811Medicaid
TX1881849180OtherMEDICARE NPI
480035345OtherRAILROAD PTAN
TX1164677753OtherMEDICARE NPI