Individual
DR. STACY ANNE BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
21212 NORTHWEST FWY STE 605, CYPRESS, TX 77429-5889
(281) 955-7577
(281) 955-5875
Mailing address
11800 FM 1960 RD W, HOUSTON, TX 77065-3840
(281) 664-2107
(281) 955-5875
Taxonomy
Speciality
Code
Description
License number
State
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
M0651
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8F4308
BC/BS PIN
TX
Enumeration date
05/23/2006
Last updated
05/08/2018
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