=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598295289
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RASHMI KUTNIKAR BARR DDS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/14/2017
-----------------------------------------------------
Last Update Date | 10/11/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6141 MCPHERSON BLVD STE #141
-----------------------------------------------------
City | FORT WORTH
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76123
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-259-0356
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8944 ARMSTRONG CT
-----------------------------------------------------
City | BENBROOK
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76126-2452
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-503-3436
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 32984
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------