John Barnett MD PA

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

D5910 Issued in TX

Legal business name

JOHN BARNETT MD PA

Doing business as

Revive Men's Clinic

Practice address

2129 Martin Dr
Suite 200
Bedford, TX 76021-5995

Phone

(817) 391-0130

Fax

(817) 391-0136

NPI assigned

Aug 5, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Marie Serna

Title

Office Director

Phone

(817) 391-0130

Specialties & licenses 1

Addresses

Other names 1

• Revive Men's Clinic Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407715200000",
    "number": "1295144186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2129 MARTIN DR",
            "address_2": "SUITE 200",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760215995",
            "telephone_number": "817-391-0130",
            "fax_number": "817-391-0136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2129 MARTIN DR",
            "address_2": "SUITE 200",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760215995",
            "telephone_number": "817-391-0130",
            "fax_number": "817-391-0136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN BARNETT MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-05",
        "last_updated": "2014-08-11",
        "status": "A",
        "authorized_official_last_name": "SERNA",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE DIRECTOR",
        "authorized_official_telephone_number": "817-391-0130",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "TX",
            "license": "D5910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revive Men's Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Physician in Bedford, TX
• Providers in Bedford, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.