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NPI Code Detail

MEDICARE: TREVOR BAKER

MEDICARE: TREVOR BAKER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053818823
Entity Type Code : Individual
Provider Name (Legal Business Name) : TREVOR BAKER
Provider Business Mailing Address
First Line : 4807 HEATHER PASS
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78218-2748
Country : US
Telephone Number : 254-466-9030
Fax Number :
Provider Business Practice Location Address
First Line : 3615 CULEBRA RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78228-5914
Country : US
Telephone Number : 210-314-6473
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2018
Last Update Date : 06/16/2018

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Directions to “ TREVOR BAKER ” Practice Location

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