Provider Demographics
NPI:1215203807
Name:BALDWIN, BILLY J (M ED)
Entity Type:Individual
Prefix:MR
First Name:BILLY
Middle Name:J
Last Name:BALDWIN
Suffix:
Gender:M
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 ASHFORD PARK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2208
Mailing Address - Country:US
Mailing Address - Phone:832-465-3375
Mailing Address - Fax:
Practice Address - Street 1:2910 ASHFORD PARK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2208
Practice Address - Country:US
Practice Address - Phone:832-465-3375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst