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:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6807 EMMETT F LOWRY EXPY STE 101
Mailing Address - Street 2:
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77591-2543
Mailing Address - Country:US
Mailing Address - Phone:281-316-0121
Mailing Address - Fax:281-316-0122
Practice Address - Street 1:450 W MEDICAL CENTER BLVD STE 600B
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4233
Practice Address - Country:US
Practice Address - Phone:281-316-0121
Practice Address - Fax:281-316-0122
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX727663163WX0800X
TXAP143347363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WX0800XNursing Service ProvidersRegistered NurseOrthopedic