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NPI Code Detail

MEDICARE: BAILEY ALEXIS WILLOWS PA-C

MEDICARE:   BAILEY ALEXIS WILLOWS  PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA15533TX

General Provider Information

NPI Number : 1679223291
Entity Type Code : Individual
Provider Name (Legal Business Name) : BAILEY ALEXIS WILLOWS PA-C
Provider Business Mailing Address
First Line : 5449 CHATSWORTH LN
Second Line :
City : FORT WORTH
State : TX
Zip : 76244-5022
Country : US
Telephone Number : 817-455-7756
Fax Number :
Provider Business Practice Location Address
First Line : 5449 CHATSWORTH LN
Second Line :
City : FORT WORTH
State : TX
Zip : 76244-5022
Country : US
Telephone Number : 817-455-7756
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2022
Last Update Date : 01/22/2025

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Directions to “ BAILEY ALEXIS WILLOWS PA-C” Practice Location

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