Healthcare Provider Details

I. General information

NPI: 1508320714
Provider Name (Legal Business Name): BAILEY RAE DYKES M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2019
Last Update Date: 07/28/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 E PALM VALLEY BLVD STE 300
ROUND ROCK TX
78664-3045
US

IV. Provider business mailing address

503 E PALM VALLEY BLVD STE 300503E
ROUND ROCK TX
78664-3046
US

V. Phone/Fax

Practice location:
  • Phone: 512-341-9991
  • Fax:
Mailing address:
  • Phone: 512-341-9991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number115261
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: