Individual
WALTER M BAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1303 MCCULLOUGH AVE, STE 242, SAN ANTONIO, TX 78212-5604
(210) 226-8982
(210) 227-1736
Mailing address
1303 MCCULLOUGH AVE, STE 242, SAN ANTONIO, TX 78212-5604
(210) 226-8982
(210) 227-1736
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
E4184
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
082977201
—
TX
01
—
742630478
CHAMPUS
—
01
—
86M432
BCBS
—
Enumeration date
11/21/2006
Last updated
06/29/2010
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