Provider Demographics
NPI:1053361493
Name:TRAVIS-BARNER, GEORJINA BREA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:GEORJINA
Middle Name:BREA
Last Name:TRAVIS-BARNER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2009 S JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-2432
Mailing Address - Country:US
Mailing Address - Phone:806-220-2304
Mailing Address - Fax:
Practice Address - Street 1:5135 PLAINS BLVD
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-4515
Practice Address - Country:US
Practice Address - Phone:806-352-2708
Practice Address - Fax:806-354-0675
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX43219183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist