Provider Demographics
NPI:1750005716
Name:SLAYTON, BAILEY (PA-C)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:
Last Name:SLAYTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:BAILEY
Other - Middle Name:
Other - Last Name:FITHIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:5917 CROSSTOWN EXPRESSWAY SH 286
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78417
Mailing Address - Country:US
Mailing Address - Phone:361-854-0811
Mailing Address - Fax:361-806-5040
Practice Address - Street 1:5917 CROSSTOWN EXPRESSWAY SH 286
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78417
Practice Address - Country:US
Practice Address - Phone:361-854-0811
Practice Address - Fax:361-806-5040
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA16195363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty