Individual
BRENT WYATT BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
104 PLAZA DR, RED OAK, TX 75154-3981
(469) 916-9750
(469) 916-9782
Mailing address
104 PLAZA DR, RED OAK, TX 75154-3981
(469) 916-9750
(469) 916-9782
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA04634
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
217344504
—
TX
Enumeration date
08/06/2007
Last updated
02/06/2026
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