Provider Demographics
NPI:1144687328
Name:BARARD, ANGELA
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:BARARD
Suffix:
Gender:F
Credentials:
Other - Prefix:MR
Other - First Name:MARCUS
Other - Middle Name:
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1119 ESTERS RD
Mailing Address - Street 2:APT 1924
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-9356
Mailing Address - Country:US
Mailing Address - Phone:469-463-4148
Mailing Address - Fax:
Practice Address - Street 1:1119 ESTERS RD
Practice Address - Street 2:APT 1924
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-9356
Practice Address - Country:US
Practice Address - Phone:469-463-4148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-19
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29281624172A00000X
TX02244466172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver