Provider Demographics
NPI:1710098769
Name:BAUER, RICHARD LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LEE
Last Name:BAUER
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:7400 MERTON MINTER ST
Mailing Address - Street 2:CHIEF OF STAFF -SOUTH TEXAS VETERANS HELATH CARE SYSTEM
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4404
Mailing Address - Country:US
Mailing Address - Phone:210-617-5176
Mailing Address - Fax:210-617-5167
Practice Address - Street 1:7400 MERTON MINTER ST
Practice Address - Street 2:CHIEF OF STAFF -SOUTH TEXAS VETERANS HELATH CARE SYSTEM
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4404
Practice Address - Country:US
Practice Address - Phone:210-617-5176
Practice Address - Fax:210-617-5167
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXE8312207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80882VOtherBLUE CROSS BLUE SHIELD