Provider Demographics
NPI:1891506051
Name:BARRETT, CARLOS
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:
Last Name:BARRETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2756 SWEETBRIAR LN
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-8549
Mailing Address - Country:US
Mailing Address - Phone:703-725-1776
Mailing Address - Fax:
Practice Address - Street 1:4045 S GREAT SOUTHWEST PKWY STE 100
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-3837
Practice Address - Country:US
Practice Address - Phone:972-375-0028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXVTH2830343900000X
TXNNR8457343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)