Provider Demographics
NPI:1144270992
Name:BARKER, WADE NEAL (MD, FACS)
Entity type:Individual
Prefix:DR
First Name:WADE
Middle Name:NEAL
Last Name:BARKER
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:12222 N CENTRAL EXPY
Mailing Address - Street 2:STE. 300
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-3755
Mailing Address - Country:US
Mailing Address - Phone:972-270-4800
Mailing Address - Fax:214-367-1153
Practice Address - Street 1:12222 N CENTRAL EXPY
Practice Address - Street 2:STE. 300
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3755
Practice Address - Country:US
Practice Address - Phone:972-270-4800
Practice Address - Fax:214-367-1153
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ1859208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX129096706Medicaid
TX129096706Medicaid
TXF57228Medicare UPIN