Provider Demographics
NPI:1265792964
Name:BAKER, NOELLE AISSA (MD)
Entity type:Individual
Prefix:DR
First Name:NOELLE
Middle Name:AISSA
Last Name:BAKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NOELLE
Other - Middle Name:AISSA
Other - Last Name:FERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 W HWY 6
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-5591
Mailing Address - Country:US
Mailing Address - Phone:254-772-5454
Mailing Address - Fax:254-772-6464
Practice Address - Street 1:601 W HWY 6
Practice Address - Street 2:SUITE 101
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-5591
Practice Address - Country:US
Practice Address - Phone:254-772-5454
Practice Address - Fax:254-772-6464
Is Sole Proprietor?:No
Enumeration Date:2012-05-29
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ8243207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology