Healthcare Provider Details

I. General information

NPI: 1295409258
Provider Name (Legal Business Name): BARBARA ANN WALKER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2021
Last Update Date: 08/04/2021
Certification Date: 08/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5321 CANFIELD LN
FORNEY TX
75126-4103
US

IV. Provider business mailing address

5321 CANFIELD LN
FORNEY TX
75126-4103
US

V. Phone/Fax

Practice location:
  • Phone: 972-515-0508
  • Fax:
Mailing address:
  • Phone: 972-515-0508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number32072464954
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: