Individual
JOHN ALAN BACCUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RT, CRT-NPS, RST
Contact information
Practice address
5000 EL DORADO PARKWAY, SUITE 150, BOX 312, FRISCO, TX 75033
(940) 391-7155
Mailing address
5000 EL DORADO PARKWAY, SUITE 150, BOX 312, FRISCO, TX 75033
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
01/24/2014
Last updated
01/24/2014
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