MEDICARE: BARBRE ORTHODONTICS, P.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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	14900	TX

General Provider Information

NPI Number	:	1437335858
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARBRE ORTHODONTICS, P.A.

Provider Business Mailing Address
First Line	:	5201 S COOPER ST
Second Line	:	STE 123
City	:	ARLINGTON
State	:	TX
Zip	:	76017-5933
Country	:	US
Telephone Number	:	817-472-8877
Fax Number	:

Provider Business Practice Location Address
First Line	:	5201 S COOPER ST
Second Line	:	STE 123
City	:	ARLINGTON
State	:	TX
Zip	:	76017-5933
Country	:	US
Telephone Number	:	817-472-8877
Fax Number	:

Authorized Official
Title or Position	:	OWNER/OPERATOR
Name	:	RAYMOND EARL BARBRE
Credential	:
Telephone Number	:	817-472-8877

Provider Enumeration Date	:	01/16/2008
Last Update Date	:	01/16/2008

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