Provider Demographics
NPI:1598893828
Name:BAILEY, MALCOLM D JR (DC)
Entity Type:Individual
Prefix:DR
First Name:MALCOLM
Middle Name:D
Last Name:BAILEY
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:MALCOLM
Other - Middle Name:
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:919 MILAM ST
Mailing Address - Street 2:SUITE T-950
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-5343
Mailing Address - Country:US
Mailing Address - Phone:713-739-7070
Mailing Address - Fax:713-739-8200
Practice Address - Street 1:919 MILAM ST
Practice Address - Street 2:SUITE T-950
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-5343
Practice Address - Country:US
Practice Address - Phone:713-739-7070
Practice Address - Fax:713-739-8200
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2965111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX603564Medicare ID - Type Unspecified
TXU24450Medicare UPIN