Provider Demographics
NPI:1326193715
Name:BARBER, SANDRA BUCKMASTER (RN, CRNFA)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:BUCKMASTER
Last Name:BARBER
Suffix:
Gender:F
Credentials:RN, CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 886
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76101-0886
Mailing Address - Country:US
Mailing Address - Phone:817-457-5431
Mailing Address - Fax:817-496-8546
Practice Address - Street 1:5024 MEADOWBROOK DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76103-3423
Practice Address - Country:US
Practice Address - Phone:817-457-5431
Practice Address - Fax:817-496-8546
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX238441163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant