Provider Demographics
NPI:1043214844
Name:BAILEY, ALISON ANNE (OD)
Entity Type:Individual
Prefix:DR
First Name:ALISON
Middle Name:ANNE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 207261
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-7261
Mailing Address - Country:US
Mailing Address - Phone:636-200-4393
Mailing Address - Fax:636-527-0766
Practice Address - Street 1:7510 PINEVILLE MATTHEWS RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-3906
Practice Address - Country:US
Practice Address - Phone:704-542-2844
Practice Address - Fax:704-542-3386
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1656152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1656OtherSTATE OPTOMETRY LICENSE
NC890913NMedicaid
NCU70093Medicare UPIN
NCNC5329AMedicare PIN
NC890913NMedicaid