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General NPI Number Information
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NPI Number | 1831192525
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Entity Type | Individual
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Provider Name | JOHN L BAEKE M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 423 TREELINE PARK STE 310
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City | SAN ANTONIO
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State | TX
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Zip | 78209-2079
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Country | US
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Telephone | 918-380-2525
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Fax | 530-430-2026
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Provider Business Mailing Address
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Address Line | 26 DI LUSSO DR
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City | BOERNE
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State | TX
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Zip | 78006-4703
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Country | US
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Telephone | 918-380-2525
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Fax | 530-430-2026
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | G55894
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | T2821
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | T2821
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License Number State | TX
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