Individual
MARK M BARRET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8288 S BROADWAY AVE, TYLER, TX 75703-5262
(903) 606-7060
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6450
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
J3978
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
122991
SUPERIOR/CHIPS
TX
05
—
136283208
—
TX
05
—
136283211
—
TX
05
—
136283212
—
TX
01
—
5152004
AETNA
TX
01
—
752616977118
TRICARE
TX
01
—
83Y676
BCBS
TX
01
—
8DC103
BCBS
TX
01
—
TAX ID AND 027
TRICARE
TX
Enumeration date
01/26/2006
Last updated
12/08/2014
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