Provider Demographics
NPI:1851319545
Name:BAILEY, CHRISTOPHER WILLIAM (MD, FACS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:WILLIAM
Last Name:BAILEY
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6210 E HWY 290
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1142
Mailing Address - Country:US
Mailing Address - Phone:512-483-9569
Mailing Address - Fax:512-406-6216
Practice Address - Street 1:1401 MEDICAL PARKWAY
Practice Address - Street 2:BLDG B SUTIE 200
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7464
Practice Address - Country:US
Practice Address - Phone:512-260-1581
Practice Address - Fax:512-406-7309
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60331556208600000X
TXN8370208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX40204316OtherDPS
WAMD60331556OtherWASHINGTON DOH
TX341181104Medicaid
TXN8370OtherSTATE LICENSE
TX341181103Medicaid
56737OtherTHE AMERICAN BOARD OF SURGERY
56737OtherTHE AMERICAN BOARD OF SURGERY
TX376149YKXYMedicare PIN
TX341181104Medicaid