MEDICARE: GLYNNIS JOAN BAROT

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	363LP0200X	Pediatric Nurse Practitioner	1014920	TX

General Provider Information

NPI Number	:	1053087361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLYNNIS JOAN BAROT

Provider Business Mailing Address
First Line	:	3600 GASTON AVE STE 1109
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75246-1811
Country	:	US
Telephone Number	:	214-827-7081
Fax Number	:

Provider Business Practice Location Address
First Line	:	3600 GASTON AVE STE 1109
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75246-1811
Country	:	US
Telephone Number	:	214-827-7081
Fax Number	:

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

Provider Enumeration Date	:	08/17/2021
Last Update Date	:	08/18/2025

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Directions to “ GLYNNIS JOAN BAROT ” Practice Location

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