MEDICARE: MR. SCOTT BARKOUSKIE PTA

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	225200000X	Physical Therapy Assistant	2055822	TX

General Provider Information

NPI Number	:	1699961839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SCOTT BARKOUSKIE PTA

Provider Business Mailing Address
First Line	:	586A LCR 463
Second Line	:
City	:	MEXIA
State	:	TX
Zip	:	76667-2650
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1816 TILE FACTORY RD
Second Line	:
City	:	PALESTINE
State	:	TX
Zip	:	75803-8472
Country	:	US
Telephone Number	:	903-723-0950
Fax Number	:

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

Provider Enumeration Date	:	09/21/2007
Last Update Date	:	09/21/2007

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Directions to “ MR. SCOTT BARKOUSKIE PTA” Practice Location

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