Provider Demographics
NPI:1578538823
Name:BAILEY, KATHLEEN M (MD)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:M
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5920 SARATOGA BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-4105
Mailing Address - Country:US
Mailing Address - Phone:361-994-5454
Mailing Address - Fax:361-994-5455
Practice Address - Street 1:5920 SARATOGA BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4105
Practice Address - Country:US
Practice Address - Phone:361-994-5454
Practice Address - Fax:361-994-5455
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9697174400000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX168926701Medicaid
TXI20312Medicare UPIN
TX168926701Medicaid