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General NPI Number Information
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NPI Number | 1114345675
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Entity Type | Organization
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Legal Business Name | DR. MARKITTA BARNETT
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Dates
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Enumeration Date | 04/02/2014
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Last Update Date | 07/02/2014
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Provider Practice Location Address
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Address Line | 2490 7TH ST BLDG 372
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City | FORT SAM HOUSTON
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State | TX
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Zip | 78234-7613
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Country | US
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Telephone | 210-223-1104
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Fax | 360-935-8560
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Provider Business Mailing Address
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Address Line | PO BOX 592208
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City | SAN ANTONIO
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State | TX
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Zip | 78259-0160
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Country | US
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Telephone | 210-223-1104
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Fax | 360-935-8560
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Authorized Official
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Title or Position | OWNER/ OPTOMETRIST
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Name | DR. MARKITTA SAMONE BARNETT
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Credential | O.D.
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Telephone | 210-592-3641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 7774T
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 7281T
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License Number State | TX
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