Healthcare Provider Details

I. General information

NPI: 1144842196
Provider Name (Legal Business Name): BARRETT ESTESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2020
Last Update Date: 05/13/2020
Certification Date: 05/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 OLD PECOS TRL
SANTA FE NM
87505-4759
US

IV. Provider business mailing address

1 SUNLIT DR E
SANTA FE NM
87508-8993
US

V. Phone/Fax

Practice location:
  • Phone: 281-627-7328
  • Fax:
Mailing address:
  • Phone: 281-627-7328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: BARRETT ESTESS
Title or Position: MANAGING MEMBER
Credential:
Phone: 281-627-7328