Healthcare Provider Details

I. General information

NPI: 1285873422
Provider Name (Legal Business Name): DANIEL CRAIG BAKER RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2009
Last Update Date: 02/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12647 OLIVE BLVD SUITE 600
SAINT LOUIS MO
63141-6393
US

IV. Provider business mailing address

20 WHITE BARK PL
THE WOODLANDS TX
77381-4622
US

V. Phone/Fax

Practice location:
  • Phone: 800-325-3982
  • Fax: 877-685-9880
Mailing address:
  • Phone: 281-364-0658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number24105
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: