MEDICARE: DR. LYNDA J BARRY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	H7990	TX

General Provider Information

NPI Number	:	1043297849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LYNDA J BARRY MD

Provider Business Mailing Address
First Line	:	9821 CHINA SPRING RD
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76708-4800
Country	:	US
Telephone Number	:	254-202-7400
Fax Number	:	254-202-7450

Provider Business Practice Location Address
First Line	:	9821 CHINA SPRING RD
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76708-4800
Country	:	US
Telephone Number	:	254-202-7400
Fax Number	:	254-202-7450

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	10/12/2016

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