| Doctor Name: | BARRY CRAIG ANCINEC |
| NPI Number: | 1194800029 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 3549 Gilmer Road Suite D Longview, TX - 756041257 |
| Business Phone Number: | 9032977669 |
| Business Fax Number: | 9032974873 |
| Mailing Address: | 3549 Gilmer Road, Suite D LONGVIEW |
| State: | TX |
| Postal Code: | 756041257 |
| Phone Number: | 9032977669 |
| Fax Number: | 9032974873 |
| NPI Enumeration Date: | 10/26/2006 |
| NPI Last Update Date: | 04/02/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | 11/26/2007 |
| NPI Reactivation Date: | 03/06/2013 |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |