Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | BP10050865 | TX |
Y | 2080N0001X | Neonatal-Perinatal Doctor | R2277 | TX |
NPI | 1073928958 |
---|---|
Provider Name | Stephen Baird |
First Address | Beaumont, TX 77720-0236 |
Second Address | Denison, TX 75020-4584 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2014 |
Last Update Date | 01/04/2021 |