Provider Demographics
NPI:1306517941
Name:BAILEY, TEIA C (NP)
Entity type:Individual
Prefix:
First Name:TEIA
Middle Name:C
Last Name:BAILEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:TEIA
Other - Middle Name:C
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:2540 N GALLOWAY AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-4813
Mailing Address - Country:US
Mailing Address - Phone:469-930-0090
Mailing Address - Fax:
Practice Address - Street 1:2540 N GALLOWAY AVE STE 204
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-4813
Practice Address - Country:US
Practice Address - Phone:469-930-0090
Practice Address - Fax:682-398-0889
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-23
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1055186363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily