=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861970352
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SARAH REBECCA BARTON MS CCC-SLP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/06/2018
-----------------------------------------------------
Last Update Date | 08/06/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2730 N STEMMONS FWY STE M-21
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75207-2279
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-331-9100
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1936 ROSE CT
-----------------------------------------------------
City | GRAPEVINE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76051-6991
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-338-6914
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | 110894
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------