MEDICARE: MRS. SANDRA BUCKMASTER BARBER R.N., C.R.N.F.A.

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	163WR0006X	Registered Nurse First Assistant	238441	TX

General Provider Information

NPI Number	:	1326193715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SANDRA BUCKMASTER BARBER R.N., C.R.N.F.A.

Provider Business Mailing Address
First Line	:	PO BOX 886
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76101-0886
Country	:	US
Telephone Number	:	817-457-5431
Fax Number	:	817-496-8546

Provider Business Practice Location Address
First Line	:	5024 MEADOWBROOK DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76103-3423
Country	:	US
Telephone Number	:	817-457-5431
Fax Number	:	817-496-8546

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

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	07/08/2007

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