Basic Information
| Provider Information | |||||||||
| NPI: | 1659361194 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARNHARDT | ||||||||
| FirstName: | MARK | ||||||||
| MiddleName: | ALAN | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3100 SCHOFIELD RD | ||||||||
| Address2: | BLDG 1179 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782347577 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2109163160 | ||||||||
| FaxNumber: | 2108082345 | ||||||||
| Practice Location | |||||||||
| Address1: | 3551 ROGER BROOKE DR | ||||||||
| Address2: | DEPARTMENT OF PEDIATRICS/ADOLESCENT MEDICINE | ||||||||
| City: | FORT SAM HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782344504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2109163160 | ||||||||
| FaxNumber: | 2108082345 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2005 | ||||||||
| LastUpdateDate: | 09/12/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | L2127 | TX | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.