1902086903 NPI number — CYNTHIA LEAH BAILEY-DELESBORE WNP

Table of content: CYNTHIA LEAH BAILEY-DELESBORE WNP (NPI 1902086903)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902086903 NPI number — CYNTHIA LEAH BAILEY-DELESBORE WNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BAILEY-DELESBORE
Provider First Name:
CYNTHIA
Provider Middle Name:
LEAH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
WNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BAILEY
Provider Other First Name:
CYNTHIA
Provider Other Middle Name:
LEAH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
WNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1902086903
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/10/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4780
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77210-4780
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-873-3450
Provider Business Mailing Address Fax Number:
713-798-1188

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1504 TAUB LOOP
Provider Second Line Business Practice Location Address:
ATTN: GYN ONC
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77030-1608
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-873-6019
Provider Business Practice Location Address Fax Number:
713-440-1270
Provider Enumeration Date:
11/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LW0102X , with the licence number:  245313 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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