Provider Demographics
NPI:1730547175
Name:ADAMS, BAILEY PAIGE (LAT)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:PAIGE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 W LOOP 289
Mailing Address - Street 2:APT. 127
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79407-3230
Mailing Address - Country:US
Mailing Address - Phone:806-994-0459
Mailing Address - Fax:
Practice Address - Street 1:3201 W LOOP 289
Practice Address - Street 2:APT. 127
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79407-3230
Practice Address - Country:US
Practice Address - Phone:806-994-0459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-31
Last Update Date:2016-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT6245174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator