Provider Demographics
NPI:1891152260
Name:BARDEN MEDICAL MANAGEMENT, LLC
Entity type:Organization
Organization Name:BARDEN MEDICAL MANAGEMENT, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-374-1876
Mailing Address - Street 1:1907 CYPRESS CREEK RD
Mailing Address - Street 2:SUITE #108
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-4150
Mailing Address - Country:US
Mailing Address - Phone:512-374-1876
Mailing Address - Fax:
Practice Address - Street 1:1907 CYPRESS CREEK RD
Practice Address - Street 2:SUITE #108
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-4150
Practice Address - Country:US
Practice Address - Phone:512-374-1876
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-15
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty