Provider Demographics
NPI:1891949731
Name:MALCOLM D. BAILEY, JR., D.C.,P.C.
Entity Type:Organization
Organization Name:MALCOLM D. BAILEY, JR., D.C.,P.C.
Other - Org Name:MALCOLM BAILEY, D.C.
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MALCOLM
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:713-739-7070
Mailing Address - Street 1:919 MILAM ST.
Mailing Address - Street 2:SUITE T-950
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-5343
Mailing Address - Country:US
Mailing Address - Phone:713-739-7070
Mailing Address - Fax:713-739-8200
Practice Address - Street 1:919 MILAM ST.
Practice Address - Street 2:SUITE T-950
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-5343
Practice Address - Country:US
Practice Address - Phone:713-739-7070
Practice Address - Fax:713-739-8200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2965111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX603564Medicare PIN
TXU24450Medicare UPIN