=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831250877
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BARBARA A PICKERING DDS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/13/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8333 STEWART RD
-----------------------------------------------------
City | GALVESTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77554
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 409-744-4330
-----------------------------------------------------
Fax | 409-744-6035
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 16807
-----------------------------------------------------
City | GALVESTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77552-6807
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 409-744-4330
-----------------------------------------------------
Fax | 409-744-6035
-----------------------------------------------------
=====================================================
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 | 13010
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------