Basic Information
| Provider Information | |||||||||
| NPI: | 1053769059 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARBUT | ||||||||
| FirstName: | ALEXIS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1615 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770098525 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7132222272 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1425 PORTLAND AVE | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146213011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5859225067 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2016 | ||||||||
| LastUpdateDate: | 10/12/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | S1560 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 314848 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | S1560 | TX | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 314848 | NY | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.