Provider Demographics
NPI:1205454600
Name:BAKER, LAITH ABU
Entity type:Individual
Prefix:
First Name:LAITH
Middle Name:ABU
Last Name:BAKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1242 BOBCAT PASS
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4002
Mailing Address - Country:US
Mailing Address - Phone:210-986-0889
Mailing Address - Fax:
Practice Address - Street 1:1242 BOBCAT PASS
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4002
Practice Address - Country:US
Practice Address - Phone:210-986-0889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-12
Last Update Date:2020-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health