Provider Demographics
NPI:1467082594
Name:BAILEY, AMAKA OKEKE
Entity Type:Individual
Prefix:DR
First Name:AMAKA
Middle Name:OKEKE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 DOUBLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-3800
Mailing Address - Country:US
Mailing Address - Phone:361-587-6062
Mailing Address - Fax:
Practice Address - Street 1:109 DAVID DUVAL CT
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-5814
Practice Address - Country:US
Practice Address - Phone:512-761-7664
Practice Address - Fax:512-870-9017
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-16
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79710101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional