Provider Demographics
NPI:1962707356
Name:BAYLESS, BARBIE OWEN (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:BARBIE
Middle Name:OWEN
Last Name:BAYLESS
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 COMET RANCH RD
Mailing Address - Street 2:
Mailing Address - City:TRINIDAD
Mailing Address - State:TX
Mailing Address - Zip Code:75163-4040
Mailing Address - Country:US
Mailing Address - Phone:903-778-4587
Mailing Address - Fax:
Practice Address - Street 1:324 COMET RANCH RD
Practice Address - Street 2:
Practice Address - City:TRINIDAD
Practice Address - State:TX
Practice Address - Zip Code:75163-4040
Practice Address - Country:US
Practice Address - Phone:903-778-4587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-5023-5225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist