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General NPI Number Information
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NPI Number | 1629259346
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Entity Type | Organization
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Legal Business Name | GEORGE C BAKATSAS
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Dates
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Enumeration Date | 11/21/2007
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Last Update Date | 06/06/2018
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Provider Practice Location Address
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Address Line | 6849 82ND STREET SUITE 102
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City | LUBBOCK
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State | TX
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Zip | 79424
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Country | US
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Telephone | 806-300-0134
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Fax | 806-300-0851
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Provider Business Mailing Address
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Address Line | PO BOX 98
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City | WOLFFORTH
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State | TX
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Zip | 79382-0098
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Country | US
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Telephone | 806-300-0134
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Fax | 806-300-0851
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. GEORGE C BAKATSAS
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Credential | DPM
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Telephone | 832-768-6142
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 1316
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License Number State | TX
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