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General NPI Number Information
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NPI Number | 1770127995
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Entity Type | Individual
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Provider Name | SHELIQUE BAILEY PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/30/2019
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Last Update Date | 08/29/2024
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Provider Practice Location Address
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Address Line | 978 MARJORIE STREET UNIT 2
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City | HOUSTON
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State | TX
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Zip | 77088
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Country | US
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Telephone | 347-695-6819
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Fax |
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Provider Business Mailing Address
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Address Line | 3007 OLINVILLE AVE APT 3
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City | BRONX
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State | NY
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Zip | 10467-6707
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Country | US
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Telephone |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9115247
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA18066
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License Number State | TX
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