Basic Information
| Provider Information | |||||||||
| NPI: | 1003903394 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FAULKNER | ||||||||
| FirstName: | BARBARA | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1908 | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 754031908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9034555986 | ||||||||
| FaxNumber: | 9034544621 | ||||||||
| Practice Location | |||||||||
| Address1: | 8 EAST SIDE PLAZA | ||||||||
| Address2: | |||||||||
| City: | LADONIA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75449 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9033677213 | ||||||||
| FaxNumber: | 9033677215 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA02653 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.