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Individual

MR. JASON SHAY BARNETTE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7201
(214) 648-6400
(214) 648-5461
Mailing address
P.O. BOX 845347, DALLAS, TX 75284-5347
(214) 645-0078

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
657503
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
159977101
TX
05
1599771106
TX
01
75-0818167-015
TRICARE
TX
01
8050UJ
BCBS
TX
01
P01394733
RAILROAD MEDICARE
TX
Enumeration date
06/15/2006
Last updated
09/12/2018
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