Organization Name: | LAWRENCE RAY BAILEY MD PLLC |
NPI Number: | 1710376439 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LAWRENCE RAY BAILEY (OWNER) |
Mailing Address: | 1711 W Wheeler Ave Suite 3 Aransas Pass |
State: | TX US |
Postal Code: | 783364536 |
Phone Number: | 3612263434 |
Fax Number: | 3617584949 |
NPI Enumeration Date: | 01/19/2015 |
NPI Last Update Date: | 01/19/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | F9158 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |