Provider Demographics
NPI:1427118520
Name:BARINQUE, MARK ANDREW (DPM)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:ANDREW
Last Name:BARINQUE
Suffix:
Gender:M
Credentials:DPM
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 94161
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79493-4161
Mailing Address - Country:US
Mailing Address - Phone:806-793-6811
Mailing Address - Fax:806-793-9278
Practice Address - Street 1:2204 ITHACA AVE
Practice Address - Street 2:STE C
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1300
Practice Address - Country:US
Practice Address - Phone:806-793-6811
Practice Address - Fax:806-793-9278
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2015-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1250213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092825102Medicaid
TX092825102Medicaid
TX00N61CMedicare PIN