=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215736004
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STEVEN DAVID BAKER PHARMD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/12/2025
-----------------------------------------------------
Last Update Date | 03/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2401 S 31ST ST # MS -2204
-----------------------------------------------------
City | TEMPLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76508-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 254-724-7409
-----------------------------------------------------
Fax | 254-724-7408
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2401 S 31ST ST # MS -2204
-----------------------------------------------------
City | TEMPLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76508-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 254-724-7409
-----------------------------------------------------
Fax | 254-724-7408
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207PT0002X
-----------------------------------------------------
Taxonomy Name | Medical Toxicology (Emergency Medicine) Physician
-----------------------------------------------------
License Number | 31826
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------