Provider Demographics
NPI:1366818445
Name:BAYLESS, BRIAN ALLEN (DPT)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:ALLEN
Last Name:BAYLESS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 RAMADA DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062-5909
Mailing Address - Country:US
Mailing Address - Phone:734-765-6352
Mailing Address - Fax:
Practice Address - Street 1:1525 RAMADA DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77062-5909
Practice Address - Country:US
Practice Address - Phone:734-765-6352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1204600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist