Provider Demographics
NPI:1407059280
Name:BAILEY, JASON RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:RICHARD
Last Name:BAILEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 980790
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-9998
Mailing Address - Country:US
Mailing Address - Phone:281-741-5910
Mailing Address - Fax:713-583-1113
Practice Address - Street 1:12121 RICHMOND AVE STE 101
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2420
Practice Address - Country:US
Practice Address - Phone:281-741-5910
Practice Address - Fax:713-583-1113
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM60302086S0122X, 208200000X, 207P00000X
TXM6080208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB138718Medicare PIN