Basic Information
| Provider Information | |||||||||
| NPI: | 1407870421 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BAILEY | ||||||||
| FirstName: | TERESA | ||||||||
| MiddleName: | BOWEN | ||||||||
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| Credential: | RNC, NNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 489 LEISURE LN | ||||||||
| Address2: | |||||||||
| City: | CEDAR CREEK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786123231 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1201 W 38TH ST | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787051006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123241086 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LN0000X | 678473 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Neonatal |
No ID Information.