Provider Demographics
NPI:1487602967
Name:BAILLEY, STEVEN EMIL (PHD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:EMIL
Last Name:BAILLEY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 AUGUSTA DRIVE
Mailing Address - Street 2:STE 107
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057
Mailing Address - Country:US
Mailing Address - Phone:713-914-9944
Mailing Address - Fax:713-914-9599
Practice Address - Street 1:1011 AUGUSTA DRIVE
Practice Address - Street 2:STE 107
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057
Practice Address - Country:US
Practice Address - Phone:713-914-9944
Practice Address - Fax:713-914-9599
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31046103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175394901Medicaid
TX041785901Medicaid
TX041785902Medicaid
TX680013151OtherRAIL ROAD MEDICARE
TX83030POtherBCBS
TX83024POtherBCBS
TX83030PMedicare ID - Type Unspecified
TX041785901Medicaid
TXP22890Medicare UPIN
TX041785902Medicaid