Healthcare Provider Details

I. General information

NPI: 1720059611
Provider Name (Legal Business Name): CRAIG BARKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 04/02/2021
Certification Date: 04/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6205 43RD ST
LUBBOCK TX
79407-3828
US

IV. Provider business mailing address

5219 CITY BANK PKWY STE 35
LUBBOCK TX
79407
US

V. Phone/Fax

Practice location:
  • Phone: 806-749-2263
  • Fax: 806-749-2264
Mailing address:
  • Phone: 806-761-0333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberK7654
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: