Provider Demographics
NPI:1982980587
Name:MEDINA-PALACIOS, BARBARA MONSERRAT (PA)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:MONSERRAT
Last Name:MEDINA-PALACIOS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:918 W WHEELER ST
Mailing Address - Street 2:
Mailing Address - City:BRECKENRIDGE
Mailing Address - State:TX
Mailing Address - Zip Code:76424-4237
Mailing Address - Country:US
Mailing Address - Phone:325-370-8912
Mailing Address - Fax:
Practice Address - Street 1:101 S HARTFORD ST
Practice Address - Street 2:
Practice Address - City:BRECKENRIDGE
Practice Address - State:TX
Practice Address - Zip Code:76424-4711
Practice Address - Country:US
Practice Address - Phone:254-559-3363
Practice Address - Fax:254-559-2572
Is Sole Proprietor?:No
Enumeration Date:2011-10-26
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical