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General NPI Number Information
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NPI Number | 1558680454
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Entity Type | Organization
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Legal Business Name | DAVID J. BAILEY, M.D., PA
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Dates
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Enumeration Date | 05/18/2010
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Last Update Date | 08/17/2010
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Provider Practice Location Address
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Address Line | 1111 W FRANK AVE STE. 301
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City | LUFKIN
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State | TX
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Zip | 75904-3303
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Country | US
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Telephone | 936-639-1740
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Fax | 936-639-1731
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Provider Business Mailing Address
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Address Line | 1111 W FRANK AVE STE. 301
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City | LUFKIN
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State | TX
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Zip | 75904-3303
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Country | US
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Telephone | 936-639-1740
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Fax | 936-639-1731
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID J BAILEY
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Credential | MD
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Telephone | 936-639-1740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0602X
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Taxonomy Name | Otolaryngic Allergy Physician
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License Number | J6864
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License Number State | TX
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