Healthcare Provider Details

I. General information

NPI: 1902555444
Provider Name (Legal Business Name): BAILEY WILLIAMS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2022
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13875 BEE CAVE PKWY
BEE CAVE TX
78738-6757
US

IV. Provider business mailing address

13875 BEE CAVE PKWY
BEE CAVE TX
78738-6757
US

V. Phone/Fax

Practice location:
  • Phone: 512-609-0771
  • Fax: 888-854-2849
Mailing address:
  • Phone: 512-609-0771
  • Fax: 888-854-2849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1902555444
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number1358332
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: