David Glenn Barron, LPTA

Individual provider Active NPI Skilled Nursing Facility · Pleasanton, TX

NPI 1659688281 · NPPES record last updated Sep 2, 2010

Key facts

NPI
1659688281
Entity type
Individual (NPI type 1)
Primary specialty
Skilled Nursing Facility 314000000X
License
2065916 (TX)
Practice address
404 West Goodwin St.
Pleasanton, TX 78064-4002
Phone
(830) 569-3861
NPI assigned
Sep 2, 2010
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PTA 1424MSMDSkilled Nursing Facility
2065916TXMDSkilled Nursing Facility

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 2065916 TX Yes
Skilled Nursing Facility 314000000X PTA 1424 MS

Addresses

Primary practice location

404 West Goodwin St.
Pleasanton, TX 78064-4002

Mailing address

15 Ford Rd
Hattiesburg, MS 39401-9380
Phone (601) 466-1112

Other providers in Pleasanton, TX

All providers in Pleasanton, TX · Skilled Nursing Facility in Texas

Sources for this page

Verify at the official NPI Registry.