Healthcare Provider Details

I. General information

NPI: 1154567089
Provider Name (Legal Business Name): BARKER BARIATRIC CENTER OF ROCKWALL, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2008
Last Update Date: 12/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2504 RIDGE RD SUITE 100
ROCKWALL TX
75087-2569
US

IV. Provider business mailing address

2504 RIDGE RD SUITE 100
ROCKWALL TX
75087-2569
US

V. Phone/Fax

Practice location:
  • Phone: 903-227-1088
  • Fax: 972-722-4087
Mailing address:
  • Phone: 903-227-1088
  • Fax: 972-722-4087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. LORI S. AARON
Title or Position: CEO
Credential:
Phone: 903-227-1088