Healthcare Provider Details

I. General information

NPI: 1477464246
Provider Name (Legal Business Name): KRISTYN NICOLE BARTON CPHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12350 INTERSTATE 45 N
WILLIS TX
77378-4734
US

IV. Provider business mailing address

12350 INTERSTATE 45 N
WILLIS TX
77378-4734
US

V. Phone/Fax

Practice location:
  • Phone: 936-272-1027
  • Fax: 936-272-2083
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number383123
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: