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General NPI Number Information
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NPI Number | 1326238775
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Entity Type | Organization
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Legal Business Name | M G BARBER INC
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Dates
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Enumeration Date | 07/31/2007
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 6212 CAMP BOWIE BLVD
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City | FORT WORTH
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State | TX
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Zip | 76116-5525
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Country | US
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Telephone | 817-737-6281
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Fax | 817-569-7736
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Provider Business Mailing Address
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Address Line | 6212 CAMP BOWIE BLVD
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City | FORT WORTH
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State | TX
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Zip | 76116-5525
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Country | US
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Telephone | 817-737-6281
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Fax | 817-569-7736
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Authorized Official
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Title or Position | PRESIDENT
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Name | MATTHEW G. BARBER
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Credential | O.D.
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Telephone | 817-737-6281
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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 | 5820TG
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License Number State | TX
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