Provider Demographics
NPI:1588779599
Name:BAKER, DAVID ALLEN JR (DC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:ALLEN
Last Name:BAKER
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4711 LOUETTA RD
Mailing Address - Street 2:SUITE 118
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-4351
Mailing Address - Country:US
Mailing Address - Phone:281-355-1838
Mailing Address - Fax:281-528-7441
Practice Address - Street 1:4711 LOUETTA RD
Practice Address - Street 2:SUITE 118
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-4351
Practice Address - Country:US
Practice Address - Phone:281-355-1838
Practice Address - Fax:281-528-7441
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2008-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9137111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8BM060OtherBCBS
TX608025OtherBCBS
TX8AS150OtherBCBS
TX8BM060OtherBCBS
V00044Medicare UPIN
TX8F8377Medicare PIN