Basic Information
| Provider Information | |||||||||
| NPI: | 1720724016 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARBER | ||||||||
| FirstName: | SHAYLA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1237 LACEY OAK LOOP | ||||||||
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| City: | ROUND ROCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786812184 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1900 N 14TH ST | ||||||||
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| City: | PONCA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 746012035 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5807650518 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2022 | ||||||||
| LastUpdateDate: | 05/17/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | 225200000X | CPO11140A | OK | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.