Provider Demographics
NPI:1609812353
Name:BAUER, VALERIE PAPACONSTANTINOU (MD)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:PAPACONSTANTINOU
Last Name:BAUER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:
Other - Last Name:PAPACONSTANTINOU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5701 HILLCREST PL
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-5011
Mailing Address - Country:US
Mailing Address - Phone:409-766-0741
Mailing Address - Fax:
Practice Address - Street 1:2600 N STATE HIGHWAY 118
Practice Address - Street 2:
Practice Address - City:ALPINE
Practice Address - State:TX
Practice Address - Zip Code:79830-2002
Practice Address - Country:US
Practice Address - Phone:432-837-3447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1500208600000X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00R518Medicare PIN
TX8G6730Medicare PIN
TXP00393666Medicare PIN
TXCI5830Medicare PIN