Individual
MR. ROBERT J BACON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1919 NORTH LOOP W STE 224, HOUSTON, TX 77008-1366
(713) 655-9410
(713) 869-4506
Mailing address
1919 NORTH LOOP W STE 224, HOUSTON, TX 77008-1366
(713) 655-9410
(713) 869-4506
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
F0861
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137509904
—
TX
05
—
137509907
—
TX
01
—
260034924
RR MEDICARE
TX
01
—
P00117827
RR MEDICARE
TX
Enumeration date
11/22/2006
Last updated
07/08/2020
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