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General NPI Number Information
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NPI Number | 1396226288
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Entity Type | Organization
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Legal Business Name | RUSSELL E BAKER, DC PC
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Dates
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Enumeration Date | 08/28/2018
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Last Update Date | 08/28/2018
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Provider Practice Location Address
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Address Line | 15901 CENTRAL COMMERCE DR STE 503
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City | PFLUGERVILLE
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State | TX
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Zip | 78660-2046
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Country | US
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Telephone | 512-989-8111
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Fax | 512-989-8181
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Provider Business Mailing Address
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Address Line | 15901 CENTRAL COMMERCE DR STE 503
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City | PFLUGERVILLE
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State | TX
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Zip | 78660-2046
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Country | US
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Telephone | 512-989-8111
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Fax | 512-989-8181
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Authorized Official
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Title or Position | OWNER
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Name | RUSSELL E BAKER
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Credential | DC
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Telephone | 512-989-8111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 8886
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License Number State | TX
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