Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | H6768 | TX |
NPI | 1003921909 |
---|---|
Provider Name | Steven R Bailey |
First Address | San Antonio, TX 78229-3901 |
Second Address | San Antonio, TX 78229-4403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 22/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
105779601 | (05) | TX |
105779602 | CIDC (01) | TX |