MEDICARE: DR. BARBARA J STARK BAXTER MD

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	207RA0201X	Allergy & Immunology (Internal Medicine) Physician	F7931	TX

General Provider Information

NPI Number	:	1720035637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARBARA J STARK BAXTER MD

Provider Business Mailing Address
First Line	:	6114 SHERRY LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75225-6301
Country	:	US
Telephone Number	:	214-363-8653
Fax Number	:	214-368-4384

Provider Business Practice Location Address
First Line	:	6114 SHERRY LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75225-6301
Country	:	US
Telephone Number	:	214-363-8653
Fax Number	:	214-368-4384

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

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	08/03/2010

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