Provider Demographics
NPI:1720087349
Name:BARTOS, JUSTIN VICTOR III (MD)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:VICTOR
Last Name:BARTOS
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4300 CITY POINT DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-8380
Mailing Address - Country:US
Mailing Address - Phone:817-255-1940
Mailing Address - Fax:817-255-1977
Practice Address - Street 1:1604 HOSPITAL PKWY STE 402
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-6932
Practice Address - Country:US
Practice Address - Phone:817-848-4110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3139207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00T83UOtherMEDICARE PTAN
TX098615005Medicaid
TXC13233Medicare UPIN
TX83Y892Medicare ID - Type Unspecified