MEDICARE: DR. BARRY K BARTEE D.D.S., 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	1223G0001X	General Practice Dentistry	15011	TX

General Provider Information

NPI Number	:	1861542300
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARRY K BARTEE D.D.S., P.A.

Provider Business Mailing Address
First Line	:	4008 92ND ST
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79423-2928
Country	:	US
Telephone Number	:	806-794-6406
Fax Number	:

Provider Business Practice Location Address
First Line	:	3234 64TH ST
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79413-5760
Country	:	US
Telephone Number	:	806-792-0030
Fax Number	:	806-792-8730

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

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	06/06/2013

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