Provider Demographics
NPI:1437489739
Name:HS BAY MED LLC
Entity Type:Organization
Organization Name:HS BAY MED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:APN, CNS
Authorized Official - Phone:512-787-1736
Mailing Address - Street 1:117 CHRISTINE CIR
Mailing Address - Street 2:
Mailing Address - City:HORSESHOE BAY
Mailing Address - State:TX
Mailing Address - Zip Code:78657-6033
Mailing Address - Country:US
Mailing Address - Phone:512-787-1736
Mailing Address - Fax:830-598-4093
Practice Address - Street 1:117 CHRISTINE CIR
Practice Address - Street 2:
Practice Address - City:HORSESHOE BAY
Practice Address - State:TX
Practice Address - Zip Code:78657-6033
Practice Address - Country:US
Practice Address - Phone:512-787-1736
Practice Address - Fax:830-598-4093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-08
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ67382084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty