Provider Demographics
NPI:1942572177
Name:BAILES, BARBARA (EDDRNNP-C,GMP-RC)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:BAILES
Suffix:
Gender:F
Credentials:EDDRNNP-C,GMP-RC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16626 TORRINGTON CT
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-7544
Mailing Address - Country:US
Mailing Address - Phone:281-370-5005
Mailing Address - Fax:
Practice Address - Street 1:16626 TORRINGTON CT
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-7544
Practice Address - Country:US
Practice Address - Phone:281-370-5005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-03
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX426328363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology