Provider Demographics
NPI:1346287604
Name:BAYLESS, ROBERT E (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:BAYLESS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2120 N MACARTHUR BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-2260
Mailing Address - Country:US
Mailing Address - Phone:972-438-4636
Mailing Address - Fax:972-438-6585
Practice Address - Street 1:2120 N MACARTHUR BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-2225
Practice Address - Country:US
Practice Address - Phone:972-438-4636
Practice Address - Fax:972-438-6585
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG7161207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3076087OtherCIGNA
TX123142501Medicaid
TX88Y420OtherBLUE CROSS
TX200020098OtherRAILROAD MEDICARE
TX3076087OtherCIGNA
TX123142501Medicaid