Provider Demographics
NPI:1053606772
Name:BARTOS, ANNETTE ROSS
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:ROSS
Last Name:BARTOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316 N HIGHWAY 77
Mailing Address - Street 2:T-1962
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-5116
Mailing Address - Country:US
Mailing Address - Phone:972-923-9169
Mailing Address - Fax:
Practice Address - Street 1:1316 N HIGHWAY 77
Practice Address - Street 2:T-1962
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-5116
Practice Address - Country:US
Practice Address - Phone:972-923-9169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-10
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22374183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist