Provider Demographics
NPI:1508320714
Name:DYKES, BAILEY RAE (MS)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:RAE
Last Name:DYKES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11250 MASON RD APT 3217
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-8070
Mailing Address - Country:US
Mailing Address - Phone:409-549-5617
Mailing Address - Fax:
Practice Address - Street 1:13611 SKINNER RD STE 250
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-4692
Practice Address - Country:US
Practice Address - Phone:832-593-6767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-22
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115261235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist