Healthcare Provider Details

I. General information

NPI: 1679148191
Provider Name (Legal Business Name): BAILEY GESSLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2021
Last Update Date: 03/12/2022
Certification Date: 03/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6700 W INTERSTATE 10
SAN ANTONIO TX
78201-2009
US

IV. Provider business mailing address

5460 ROWLEY RD APT 1812
SAN ANTONIO TX
78240-4747
US

V. Phone/Fax

Practice location:
  • Phone: 210-736-6700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: