Provider Demographics
NPI:1386747012
Name:BARTON, JOHNNY MAC II (PT)
Entity type:Individual
Prefix:MR
First Name:JOHNNY
Middle Name:MAC
Last Name:BARTON
Suffix:II
Gender:M
Credentials:PT
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4700 N JOSEY LN
Mailing Address - Street 2:APT. 3628
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4693
Mailing Address - Country:US
Mailing Address - Phone:972-492-5046
Mailing Address - Fax:
Practice Address - Street 1:1100 JUPITER RD
Practice Address - Street 2:STE. 190
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-7047
Practice Address - Country:US
Practice Address - Phone:972-665-1810
Practice Address - Fax:972-665-1814
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1136463225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G3178Medicare ID - Type Unspecified