Individual
JEFFREY M BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-5302
(409) 772-2222
Mailing address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-5302
(409) 772-2222
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
OP23020
TX
103TC0700X
Clinical Psychologist
23020
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102701302
—
TX
Enumeration date
11/03/2006
Last updated
05/18/2009
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