Healthcare Provider Details

I. General information

NPI: 1538181987
Provider Name (Legal Business Name): TERRY L. BARRETT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 02/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1355 RIVER BEND DR
DALLAS TX
75247-4915
US

IV. Provider business mailing address

1355 RIVER BEND DR
DALLAS TX
75247-4915
US

V. Phone/Fax

Practice location:
  • Phone: 214-638-2000
  • Fax: 214-237-1864
Mailing address:
  • Phone: 214-638-2000
  • Fax: 214-237-1864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License NumberM0010
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberM0010
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: