Provider Demographics
NPI:1053817940
Name:BUTLER, EMILY BAKER (DO)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:BAKER
Last Name:BUTLER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:EMLIY
Other - Middle Name:N
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:4214 ANDREWS HWY STE 240
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79703-4817
Mailing Address - Country:US
Mailing Address - Phone:432-686-6605
Mailing Address - Fax:432-682-2284
Practice Address - Street 1:3415 N LOOP 250 W BLDG 4
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79707-6034
Practice Address - Country:US
Practice Address - Phone:432-221-3300
Practice Address - Fax:432-221-3313
Is Sole Proprietor?:No
Enumeration Date:2018-04-01
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2020-01853207Q00000X
TXT1644207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT1644OtherSTATE LICENSE