Provider Demographics
NPI:1346801826
Name:BAIRD, CHESTER WHITNEY (PTA)
Entity Type:Individual
Prefix:
First Name:CHESTER
Middle Name:WHITNEY
Last Name:BAIRD
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 MORNINGSIDE
Mailing Address - Street 2:
Mailing Address - City:BULLARD
Mailing Address - State:TX
Mailing Address - Zip Code:75757-5182
Mailing Address - Country:US
Mailing Address - Phone:903-570-2835
Mailing Address - Fax:
Practice Address - Street 1:19998 SADDLEBROOK DR
Practice Address - Street 2:
Practice Address - City:LINDALE
Practice Address - State:TX
Practice Address - Zip Code:75771-6382
Practice Address - Country:US
Practice Address - Phone:903-882-6400
Practice Address - Fax:903-882-6404
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant