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NPI Code Detail

MEDICARE: BRYAN BAROOTES MD

MEDICARE: BRYAN BAROOTES 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
1207Q00000XFamily Medicine Physician13512RLA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00212785OTHERLARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326040858
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYAN BAROOTES MD
Provider Business Mailing Address
First Line : PO BOX 123453
Second Line : DEPT 3453
City : DALLAS
State : TX
Zip : 75312-3453
Country : US
Telephone Number : 337-494-2772
Fax Number : 337-494-2928
Provider Business Practice Location Address
First Line : 1525 OAK PARK BLVD
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70601-8849
Country : US
Telephone Number : 337-494-6767
Fax Number : 337-494-6750
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2005
Last Update Date : 01/29/2019

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Directions to “ BRYAN BAROOTES MD” Practice Location

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