Healthcare Provider Details

I. General information

NPI: 1568196772
Provider Name (Legal Business Name): ANDREW R BARRIOS PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2022
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6975 W GLENDALE AVE STE 1600
GLENDALE AZ
85303-2611
US

IV. Provider business mailing address

3003 N CENTRAL AVE STE 1600
PHOENIX AZ
85012-2908
US

V. Phone/Fax

Practice location:
  • Phone: 602-243-7277
  • Fax: 602-323-3496
Mailing address:
  • Phone: 602-672-7168
  • Fax: 602-323-3496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10723
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: