Provider Demographics
NPI:1912949868
Name:BROOKS, BARRY D (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:D
Last Name:BROOKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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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 1:7777 FOREST LN
Practice Address - Street 2:BLDG D, SUITE 400
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2505
Practice Address - Country:US
Practice Address - Phone:972-566-7790
Practice Address - Fax:972-566-5819
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE6253207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX88112KMedicaid
TX892816Medicaid
TX8R1403OtherBLUE CROSS OF TEXAS
TX88272KMedicare PIN
TX88112KMedicaid