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Individual

KIRK W BARRON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
1250 8TH AVE, SUITE 135, FORT WORTH, TX 76104
(817) 332-8848
(817) 335-2670
Mailing address
1250 8TH AVE, SUITE 135, FORT WORTH, TX 76104
(817) 332-8848
(817) 335-2670

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA04583
TX
363AM0700X
Medical Physician Assistant
Primary
PA04583
TX
363AS0400X
Surgical Physician Assistant
PA04583
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
194565101
TX
01
8Y8718
BCBS
TX
01
P00784417
RAILROAD MEDICARE
TX
Enumeration date
04/03/2006
Last updated
11/26/2012
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