Doctor Name: | DR. WENDALL BAUMAN |
NPI Number: | 1508082132 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | J4706 |
Business Practice Address: | 11651 Toepperwein Rd Ste 201 Live Oak, TX - 782333147 |
Business Phone Number: | 2106540400 |
Business Fax Number: | 2106540460 |
Mailing Address: | 11651 Toepperwein Rd, Ste 201 LIVE OAK |
State: | TX |
Postal Code: | 782333147 |
Phone Number: | 2106540400 |
Fax Number: | 2106540460 |
NPI Enumeration Date: | 04/18/2007 |
NPI Last Update Date: | 07/07/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | J4706 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |