Provider Demographics
NPI:1346371887
Name:BAILEY, STEVEN A (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:A
Last Name:BAILEY
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 W MEDICAL CT
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76310-1767
Mailing Address - Country:US
Mailing Address - Phone:940-692-4688
Mailing Address - Fax:940-692-8388
Practice Address - Street 1:1 W MEDICAL CT
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76310-1767
Practice Address - Country:US
Practice Address - Phone:940-692-4688
Practice Address - Fax:940-692-8388
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT03332255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer