Individual
CHARLES VICTOR BAYOUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3509 22ND ST, LUBBOCK, TX 79410-1307
(806) 799-7928
(806) 788-8500
Mailing address
3509 22ND ST, LUBBOCK, TX 79410-1307
(806) 799-7928
(806) 788-8500
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
K5255
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150430003
—
TX
Enumeration date
05/31/2005
Last updated
11/09/2021
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