Provider Demographics
NPI:1326399940
Name:BAYER, ALYSON CLAIRE (LAC)
Entity Type:Individual
Prefix:
First Name:ALYSON
Middle Name:CLAIRE
Last Name:BAYER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 N THOMPSON ST
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77301-2849
Mailing Address - Country:US
Mailing Address - Phone:936-689-6975
Mailing Address - Fax:
Practice Address - Street 1:213 N THOMPSON ST
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-2849
Practice Address - Country:US
Practice Address - Phone:936-689-6975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-21
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01151171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist