MEDICARE: BARRY J LIBERONI 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	207R00000X	Internal Medicine Physician	K8293	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861470361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARRY J LIBERONI MD

Provider Business Mailing Address
First Line	:	720 AVENUE F N
Second Line	:	STE. 3
City	:	BAY CITY
State	:	TX
Zip	:	77414-9573
Country	:	US
Telephone Number	:	979-245-9797
Fax Number	:	979-245-9789

Provider Business Practice Location Address
First Line	:	720 AVENUE F N
Second Line	:	STE. 3
City	:	BAY CITY
State	:	TX
Zip	:	77414-9573
Country	:	US
Telephone Number	:	979-245-9797
Fax Number	:	979-245-9789

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

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	10/24/2025

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