MEDICARE: DR. DENNIS BERNARD BARSON JR. DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	204D00000X	Neuromusculoskeletal Medicine & OMM Physician	N0634	TX
2	207R00000X	Internal Medicine Physician	N0634	TX

General Provider Information

NPI Number	:	1588628770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS BERNARD BARSON JR. DO

Provider Business Mailing Address
First Line	:	1779 WELLS BRANCH PKWY
Second Line	:	110B
City	:	AUSTIN
State	:	TX
Zip	:	78728-7090
Country	:	US
Telephone Number	:	512-810-8948
Fax Number	:	512-294-2987

Provider Business Practice Location Address
First Line	:	1779 WELLS BRANCH PKWY
Second Line	:	110B
City	:	AUSTIN
State	:	TX
Zip	:	78728-7090
Country	:	US
Telephone Number	:	512-810-8948
Fax Number	:	512-294-2987

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	10/24/2011

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