Organization
DR MISTY D BAKER
Active
Other names
The Foot Doctor
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MISTY D BAKER D.P.M. (PODIATRIST)
(903) 753-3668
Entity
Organization
Contact information
Practice address
2840 BILL OWENS PKWY, SUITE A, LONGVIEW, TX 75605-2150
(903) 753-3668
(903) 753-3671
Mailing address
2840 BILL OWENS PKWY, SUITE A, LONGVIEW, TX 75605-2150
(903) 753-3668
(903) 753-3671
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
L1758
TX
332B00000X
Durable Medical Equipment & Medical Supplies
L1758
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0011RL
BCBS PIN
TX
05
—
189758901
—
TX
01
—
DG5248
MEDICARE RAILROAD
TX
Enumeration date
04/20/2007
Last updated
12/02/2009
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