Basic Information
Provider Information
NPI: 1780140202
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARNES
FirstName: ASHLEY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: DAVIES
OtherFirstName: ASHLEY
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: FNP
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 844658
Address2:  
City: DALLAS
State: TX
PostalCode: 752844658
CountryCode: US
TelephoneNumber: 2547248800
FaxNumber:  
Practice Location
Address1: 800 SCOTT AND WHITE DR
Address2:  
City: COLLEGE STATION
State: TX
PostalCode: 778456440
CountryCode: US
TelephoneNumber: 9792073300
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/20/2019
LastUpdateDate: 01/11/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/11/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAP140356TXY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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