Provider Demographics
NPI:1144212150
Name:BAILLARGEON, JACQUES G (MD)
Entity Type:Individual
Prefix:DR
First Name:JACQUES
Middle Name:G
Last Name:BAILLARGEON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8245 FREDERICKSBURG RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3356
Mailing Address - Country:US
Mailing Address - Phone:210-616-0022
Mailing Address - Fax:210-616-0258
Practice Address - Street 1:8245 FREDERICKSBURG RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3356
Practice Address - Country:US
Practice Address - Phone:210-616-0022
Practice Address - Fax:210-616-0258
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD73932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX083613201Medicaid
TX00L02GMedicare PIN
TX81446PMedicare PIN
TXB21057Medicare UPIN
TX083613201Medicaid