Provider Demographics
NPI:1760119002
Name:LADAY, BAILEY VICTORIA
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:VICTORIA
Last Name:LADAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 OYSTER CREEK DR STE B
Mailing Address - Street 2:
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-4119
Mailing Address - Country:US
Mailing Address - Phone:979-215-2309
Mailing Address - Fax:844-272-3168
Practice Address - Street 1:135 OYSTER CREEK DR STE B
Practice Address - Street 2:
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-4119
Practice Address - Country:US
Practice Address - Phone:979-215-2309
Practice Address - Fax:844-272-3168
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1066612163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice