Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 12095 | TX |
Y | 213EG0000X | General Practice | 12095 | TX |
NPI | 1003920505 |
---|---|
Provider Name | Dr. Alan W Baker |
First Address | Hurst, TX 76054-3439 |
Second Address | Hurst, TX 76054-3439 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2006 |
Last Update Date | 08/07/2007 |