Provider Demographics
NPI:1194727446
Name:BARKMAN & SMITH PHYSICAL THERAPY
Entity type:Organization
Organization Name:BARKMAN & SMITH PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:IRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-283-9435
Mailing Address - Street 1:1940 BEDFORD RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-5707
Mailing Address - Country:US
Mailing Address - Phone:817-283-9435
Mailing Address - Fax:817-571-4198
Practice Address - Street 1:1940 BEDFORD RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-5707
Practice Address - Country:US
Practice Address - Phone:817-283-9435
Practice Address - Fax:817-571-4198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX601960000261QP2000X
TX646300000261QP2000X
261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8D3143Medicare ID - Type UnspecifiedB MORGAN - TARRANT
TX8D1372Medicare ID - Type UnspecifiedV SMITH TARRANT
TX8D7405Medicare ID - Type UnspecifiedJ STODDARD- TARRANT
TX8D2547Medicare ID - Type Unspecified
TX8D3142Medicare ID - Type UnspecifiedB MORGAN -DALLAS
TX8D7404Medicare ID - Type UnspecifiedJ STODDARD - TARRANT
TX00129YMedicare ID - Type UnspecifiedGROUP- TARRANT COUNTY
TX8D2546Medicare ID - Type UnspecifiedR BARKMAN- DALLAS COUNTY
TX8D1370Medicare ID - Type UnspecifiedTARRANT