MEDICARE: KEITH A BARNES PA

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	363A00000X	Physician Assistant	PA00561	TX

General Provider Information

NPI Number	:	1972695518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEITH A BARNES PA

Provider Business Mailing Address
First Line	:	9229 LYNDON B JOHNSON FWY
Second Line	:	SUITE 250
City	:	DALLAS
State	:	TX
Zip	:	75243-3405
Country	:	US
Telephone Number	:	972-739-3097
Fax Number	:	972-739-2673

Provider Business Practice Location Address
First Line	:	1626 MEDICAL CENTER ST
Second Line	:	5TH FLOOR, SUITE 503
City	:	EL PASO
State	:	TX
Zip	:	79902-5010
Country	:	US
Telephone Number	:	915-546-9200
Fax Number	:	915-546-9800

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

Provider Enumeration Date	:	09/29/2006
Last Update Date	:	07/08/2007

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Directions to “ KEITH A BARNES PA” Practice Location

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