Provider Demographics
NPI:1194735662
Name:BARKER, MICHAEL P (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:P
Last Name:BARKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9643 HUEBNER RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1752
Mailing Address - Country:US
Mailing Address - Phone:210-615-3898
Mailing Address - Fax:210-615-3894
Practice Address - Street 1:9643 HUEBNER RD
Practice Address - Street 2:STE 103
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1752
Practice Address - Country:US
Practice Address - Phone:210-615-3898
Practice Address - Fax:210-290-8132
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3736208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4359078OtherAETNA
TX177350000OtherOWCP
TX250004049OtherMEDICARE R.R.
TX0343493-01Medicaid
TX3357863OtherBLUE LINK ID
TX177350000OtherOWCP
TX00K21TMedicare Oscar/Certification