Provider Demographics
NPI:1003053703
Name:KENNETH E. BAIRD, M.D., P.A.
Entity Type:Organization
Organization Name:KENNETH E. BAIRD, M.D., P.A.
Other - Org Name:KENNETH BAIRD, M.D., FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:E
Authorized Official - Last Name:BAIRD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-263-3234
Mailing Address - Street 1:3012 E HEBRON PKWY
Mailing Address - Street 2:STE 110
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4464
Mailing Address - Country:US
Mailing Address - Phone:214-263-3234
Mailing Address - Fax:
Practice Address - Street 1:3012 E HEBRON PKWY
Practice Address - Street 2:STE 110
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4464
Practice Address - Country:US
Practice Address - Phone:214-263-3234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5658261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110489505Medicaid
TX110489505Medicaid
TX8663N6Medicare PIN