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General NPI Number Information
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NPI Number | 1639885643
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Entity Type | Organization
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Legal Business Name | TRIPLE BARRY CORPORATION
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Dates
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Enumeration Date | 01/24/2023
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 5177 E INTERSTATE 20 SERVICE RD N STE 101
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City | WILLOW PARK
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State | TX
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Zip | 76087-3217
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Country | US
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Telephone | 817-609-8166
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Fax | 817-609-8162
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Provider Business Mailing Address
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Address Line | 5177 E INTERSTATE 20 SERVICE RD N STE 101
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City | WILLOW PARK
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State | TX
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Zip | 76087-3217
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Country | US
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Telephone | 817-609-8166
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROBERT YBARRA JR.
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Credential |
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Telephone | 817-374-5606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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