Provider Demographics
NPI:1215461843
Name:BARCLAY, WUBU (RN)
Entity type:Individual
Prefix:
First Name:WUBU
Middle Name:
Last Name:BARCLAY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:WUBU
Other - Middle Name:K
Other - Last Name:GOYAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3979 FERNANDO DR
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76040-3448
Mailing Address - Country:US
Mailing Address - Phone:817-729-0104
Mailing Address - Fax:
Practice Address - Street 1:3979 FERNANDO DR
Practice Address - Street 2:
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76040-3448
Practice Address - Country:US
Practice Address - Phone:817-729-0104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX802877163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse