Provider Demographics
NPI:1659753317
Name:BAUER, IAN (NP)
Entity type:Individual
Prefix:
First Name:IAN
Middle Name:
Last Name:BAUER
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1319 CHANDLER CV
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-1796
Mailing Address - Country:US
Mailing Address - Phone:713-385-7957
Mailing Address - Fax:
Practice Address - Street 1:4710 BELLAIRE BLVD STE 175
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4505
Practice Address - Country:US
Practice Address - Phone:346-356-3060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2025-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143347363LF0000X
TX727663163WX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WX0800XNursing Service ProvidersRegistered NurseOrthopedic