Provider Demographics
NPI:1215742598
Name:BAILEY, ERIC THOMAS (ATP)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:THOMAS
Last Name:BAILEY
Suffix:
Gender:M
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 VALLEY VIEW LN STE 205
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-5704
Mailing Address - Country:US
Mailing Address - Phone:972-206-7345
Mailing Address - Fax:972-522-0103
Practice Address - Street 1:2300 VALLEY VIEW LN STE 205
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75234-5704
Practice Address - Country:US
Practice Address - Phone:972-206-7345
Practice Address - Fax:972-522-0103
Is Sole Proprietor?:No
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other