MEDICARE: DEBRA BAYARD

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
1	163W00000X	Registered Nurse	666433	TX

General Provider Information

NPI Number	:	1972125474
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBRA BAYARD

Provider Business Mailing Address
First Line	:	10314 ROSEANGEL LN
Second Line	:
City	:	HELOTES
State	:	TX
Zip	:	78023-3679
Country	:	US
Telephone Number	:	210-380-3964
Fax Number	:

Provider Business Practice Location Address
First Line	:	10314 ROSEANGEL LN
Second Line	:
City	:	HELOTES
State	:	TX
Zip	:	78023-3679
Country	:	US
Telephone Number	:	210-380-3964
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2020
Last Update Date	:	05/07/2020

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Directions to “ DEBRA BAYARD ” Practice Location

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