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NPI Code Detail

MEDICARE: DR. GORDON BARTH D.O.

MEDICARE: DR. GORDON BARTH D.O.
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
1207Q00000XFamily Medicine PhysicianG3136TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18P9303OTHERTXBLUE CROSS BLUE SHIELD OF
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710913785
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GORDON BARTH D.O.
Provider Business Mailing Address
First Line : 508 N RIEDEL ST
Second Line :
City : YORKTOWN
State : TX
Zip : 78164-1810
Country : US
Telephone Number : 361-564-3383
Fax Number : 361-564-4224
Provider Business Practice Location Address
First Line : 508 N RIEDEL ST
Second Line :
City : YORKTOWN
State : TX
Zip : 78164-1810
Country : US
Telephone Number : 361-564-3383
Fax Number : 361-564-4224
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2006
Last Update Date : 09/29/2021

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Directions to “ DR. GORDON BARTH D.O.” Practice Location

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