Provider Demographics
NPI:1548228927
Name:BAUER, STEVEN M (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:M
Last Name:BAUER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:STEVEN
Other - Middle Name:M
Other - Last Name:BAUER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:20642 STONE OAK PKWY
Mailing Address - Street 2:SUITE 108
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-7363
Mailing Address - Country:US
Mailing Address - Phone:210-492-0505
Mailing Address - Fax:210-492-0504
Practice Address - Street 1:20642 STONE OAK PKWY
Practice Address - Street 2:SUITE 108
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-7362
Practice Address - Country:US
Practice Address - Phone:210-492-0505
Practice Address - Fax:210-492-0504
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2411207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00230501OtherPALMETTO RAILROAD MEDICARE
TX1177362Medicaid
TX8AW488OtherBCBS
TX0013JLOtherBCBS
TX0013JLOtherBCBS
TXG45332Medicare UPIN
G45332Medicare UPIN