Provider Demographics
NPI:1376629808
Name:BACANI, EUGENIO (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENIO
Middle Name:
Last Name:BACANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 FROSTWOOD DR
Mailing Address - Street 2:SUITE 1.100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2301
Mailing Address - Country:US
Mailing Address - Phone:713-338-4523
Mailing Address - Fax:
Practice Address - Street 1:1227 MUSEUM SQUARE DR
Practice Address - Street 2:SUITE A
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-4629
Practice Address - Country:US
Practice Address - Phone:281-265-8125
Practice Address - Fax:832-658-5430
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0982207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Y409Medicare PIN
TX8F6683Medicare UPIN
TXE04540Medicare UPIN