Provider Demographics
NPI:1598771396
Name:BAIER, MARGARET E MATYASTIK (PHD LMFT)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:E MATYASTIK
Last Name:BAIER
Suffix:
Gender:F
Credentials:PHD LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 LONDONDERRY DRIVE #10
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712
Mailing Address - Country:US
Mailing Address - Phone:254-399-0761
Mailing Address - Fax:254-399-0791
Practice Address - Street 1:305 LONDONDERRY DR STE 10
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-7906
Practice Address - Country:US
Practice Address - Phone:254-399-0761
Practice Address - Fax:254-399-0791
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4885106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX237079OtherTRICARE MENTAL HEALTH PRO
TX166BOtherBCBS MENTAL HEALTH PROVID