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General NPI Number Information
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NPI Number | 1326393174
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Entity Type | Individual
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Provider Name | SUSAN BAILEY PT, MED
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Gender | Female
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Dates
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Enumeration Date | 07/18/2012
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Last Update Date | 07/18/2012
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Provider Practice Location Address
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Address Line | 790 ROY RICHARD DR.
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City | SCHERTZ
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State | TX
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Zip | 78154
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Country | US
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Telephone | 210-659-4333
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Fax |
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Provider Business Mailing Address
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Address Line | 444 HUNTERS TROPHY
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City | NEW BRAUNFELS
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State | TX
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Zip | 78132-4776
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Country | US
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Telephone | 210-288-0261
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 1056042
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License Number State | TX
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