Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 14900 | TX |
NPI | 1073619482 |
---|---|
Provider Name | Dr. Raymond Earl Barbre |
First Address | Arlington, TX 76017-5933 |
Second Address | Arlington, TX 76017-5933 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 08/07/2007 |