Provider Demographics
NPI:1699113514
Name:BARNES, KATHRYN (RPH)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:BARNES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2109 DESCO DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-3421
Mailing Address - Country:US
Mailing Address - Phone:512-978-9086
Mailing Address - Fax:512-275-2854
Practice Address - Street 1:15 WALLER ST
Practice Address - Street 2:SUITE 515
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-5240
Practice Address - Country:US
Practice Address - Phone:512-978-9086
Practice Address - Fax:512-275-2854
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-13
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33463183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist