Individual
CHARLES EDWARD BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD.
Contact information
Practice address
4310 JAMES CASEY ST., BUILDING 1 SUITE A, AUSTIN, TX 78745
(512) 504-7411
(512) 215-8824
Mailing address
4310 JAMES CASEY ST, BUILDING 1 SUITE A, AUSTIN, TX 78745
(512) 504-7411
(512) 215-8824
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
M1485
TX
207RI0011X
Interventional Cardiology Physician
Primary
M1485
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
179907401
—
TX
01
—
378596ZSQT
PTAN
TX
Enumeration date
09/27/2005
Last updated
04/08/2021
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