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SHIRLEY JEANNE BAKER PA-C
>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1972549947
Individual Registrant: SHIRLEY JEANNE BAKER PA-C
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
607 LASSATER CENTERVILLE, TX 78533 US
Tel: 903-536-3687 Fax: 903-356-7723
Tel: 903-536-3687 Fax: 903-356-7723
Contact information for business:
1500 UNIVERSITY DR E #100 COLLEGE STATION, TX 77840-2600 US
Tel: 979-846-1100 Fax: 979-260-9390
Tel: 979-846-1100 Fax: 979-260-9390
Registration Information:
NPI: 1972549947
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers Physician Assistant | TX | PA02294 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 154467801 | TX | 05 | |
| 187842301 | TX | 05 | |
| NPI AGENCY | 1821185299 | TX | 01 |
| NPI CLINIC | 1568519122 | TX | 01 |
| 185649401 | TX | 05 | |
| 000951608 | TX | 05 | |
| 154467803 | TX | 05 | |
| 183142201 | TX | 05 | |
| TAX ID | 741715140 | TX | 01 |
