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NPI Code Detail

MEDICARE: COLIN R BAILEY MD

MEDICARE: COLIN R BAILEY MD
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
1207Q00000XFamily Medicine PhysicianJ6312TX

General Provider Information

NPI Number : 1134195449
Entity Type Code : Individual
Provider Name (Legal Business Name) : COLIN R BAILEY MD
Provider Business Mailing Address
First Line : 2100 LAKE SHORE DR
Second Line :
City : WACO
State : TX
Zip : 76708-1271
Country : US
Telephone Number : 254-537-6160
Fax Number : 254-755-6695
Provider Business Practice Location Address
First Line : 2100 LAKE SHORE DR
Second Line :
City : WACO
State : TX
Zip : 76708-1271
Country : US
Telephone Number : 254-537-6160
Fax Number : 254-755-6695
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2006
Last Update Date : 12/11/2014

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Directions to “ COLIN R BAILEY MD” Practice Location

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