Basic Information
| Provider Information | |||||||||
| NPI: | 1336189752 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARRATT | ||||||||
| FirstName: | MICHELLE | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 301448 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753031148 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7135003500 | ||||||||
| FaxNumber: | 7135122227 | ||||||||
| Practice Location | |||||||||
| Address1: | 6410 FANNIN ST STE 170 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770303003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8323257111 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2006 | ||||||||
| LastUpdateDate: | 05/11/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080A0000X | H9295 | TX | N | Allopathic & Osteopathic Physicians | Pediatrics | Adolescent Medicine | 208000000X | H9295 | TX | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 88Y642 | 01 | TN | BCBS | OTHER | 137025601 | 01 | TX | CSHCN | OTHER | 137025608 | 05 | TX | MEDICAID |