Provider Demographics
NPI:1548277882
Name:BAILEY, DAVID JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOHN
Last Name:BAILEY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1105 W FRANK AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-3340
Mailing Address - Country:US
Mailing Address - Phone:936-693-1740
Mailing Address - Fax:936-639-1734
Practice Address - Street 1:17350 ST LUKES WAY STE 200
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-4103
Practice Address - Country:US
Practice Address - Phone:936-266-2630
Practice Address - Fax:936-266-8521
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2022-09-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXJ6864207Y00000X, 207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1127938-01Medicaid
TXE01737Medicare UPIN
TXTXB102652Medicare PIN