Healthcare Provider Details

I. General information

NPI: 1285026385
Provider Name (Legal Business Name): BARRETT QUALITY MEDICAL INTERESTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2015
Last Update Date: 06/11/2024
Certification Date: 06/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 MADISON OAK DR SUITE 130
SAN ANTONIO TX
78258-3943
US

IV. Provider business mailing address

540 MADISON OAK DR STE 210
SAN ANTONIO TX
78258-3920
US

V. Phone/Fax

Practice location:
  • Phone: 210-479-3233
  • Fax: 512-485-0147
Mailing address:
  • Phone: 210-479-3233
  • Fax: 512-485-0147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number1586
License Number StateTX

VIII. Authorized Official

Name: MICHAEL J BARRETT
Title or Position: OWNER
Credential: DPM
Phone: 210-479-3233