MEDICARE: DR. STEVEN EMIL BAILLEY PHD

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
1	103TC0700X	Clinical Psychologist	31046	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	680013151	OTHER	TX	RAIL ROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	83030P	OTHER	TX	BCBS
6	83024P	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1487602967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN EMIL BAILLEY PHD

Provider Business Mailing Address
First Line	:	1011 AUGUSTA DRIVE
Second Line	:	STE 107
City	:	HOUSTON
State	:	TX
Zip	:	77057
Country	:	US
Telephone Number	:	713-914-9944
Fax Number	:	713-914-9599

Provider Business Practice Location Address
First Line	:	1011 AUGUSTA DRIVE
Second Line	:	STE 107
City	:	HOUSTON
State	:	TX
Zip	:	77057
Country	:	US
Telephone Number	:	713-914-9944
Fax Number	:	713-914-9599

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	06/23/2008

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