Provider Demographics
NPI:1164721320
Name:BAILEY, DANIELLE A (DPT)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:A
Last Name:BAILEY
Suffix:
Gender:F
Credentials:DPT
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 306393
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6393
Mailing Address - Country:US
Mailing Address - Phone:615-373-1350
Mailing Address - Fax:615-221-0954
Practice Address - Street 1:14701 SAN PEDRO AVE STE 105
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-4312
Practice Address - Country:US
Practice Address - Phone:210-238-0353
Practice Address - Fax:210-399-0383
Is Sole Proprietor?:No
Enumeration Date:2011-03-26
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1307335225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2079610OtherTEXAS BOARD OF PHYSICAL THERAPY EXAMINERS