Provider Demographics
NPI:1013186170
Name:STEVEN M. BAUER, M.D., PA
Entity Type:Organization
Organization Name:STEVEN M. BAUER, M.D., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BAUER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-492-0505
Mailing Address - Street 1:20642 STONE OAK PKWY
Mailing Address - Street 2:SUITE 108
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-7362
Mailing Address - Country:US
Mailing Address - Phone:210-492-0505
Mailing Address - Fax:210-492-0504
Practice Address - Street 1:20642 STONE OAK PKWY
Practice Address - Street 2:SUITE 108
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-7362
Practice Address - Country:US
Practice Address - Phone:210-492-0505
Practice Address - Fax:210-492-0504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2411207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0013JLOtherBCBS
TX0044RCOtherBCBS
TX163518701Medicaid
TXDD4786OtherPALMETTO RAILROAD MEDICARE
TX0013JLOtherBCBS
TXG45332Medicare UPIN