Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 5260 | CO |
N | 111NI0013X | Independent Medical Examiner | 8558 | TX |
Y | 111NR0400X | Rehabilitation Chiropractor | 8558 | TX |
NPI | 1841369238 |
---|---|
Provider Name | Dr. Michael Derrell Barnett |
First Address | Flower Mound, TX 75028-3662 |
Second Address | Flower Mound, TX 75028-3662 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 20/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7294356 | AETNA (01) | TX |
U80596 | (02) | TX |