Provider Demographics
NPI:1225718927
Name:CLINTON J BAIRD PLC
Entity Type:Organization
Organization Name:CLINTON J BAIRD PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN RELATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TYESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSQUITO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-519-4090
Mailing Address - Street 1:6130 E 81ST ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-2101
Mailing Address - Country:US
Mailing Address - Phone:512-409-9903
Mailing Address - Fax:918-493-3304
Practice Address - Street 1:1401 MEDICAL PARKWAY
Practice Address - Street 2:BUILDING B SUITE 412
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613
Practice Address - Country:US
Practice Address - Phone:512-409-9903
Practice Address - Fax:918-493-3304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty