Provider Demographics
NPI:1912486895
Name:BARKER, STEPHANIE CARROL
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:CARROL
Last Name:BARKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3195 LAMAR AVE
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-5019
Mailing Address - Country:US
Mailing Address - Phone:903-706-5001
Mailing Address - Fax:
Practice Address - Street 1:3195 LAMAR AVE
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-5019
Practice Address - Country:US
Practice Address - Phone:903-706-5001
Practice Address - Fax:903-272-8010
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-10
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2113919225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant