Healthcare Provider Details
I. General information
NPI: 1871329730
Provider Name (Legal Business Name): BAYLEE LLANAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/09/2024
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1310 WONDER WORLD DR STE 110
SAN MARCOS TX
78666-8351
US
IV. Provider business mailing address
1650 LYNDON FARM CT STE 300
LOUISVILLE KY
40223-5005
US
V. Phone/Fax
- Phone: 737-266-0300
- Fax:
- Phone: 726-202-3039
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 1400223 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: