Bacon, Annette L.

Bacon, Annette L. is an individual health care provider with primary practice located at 5201 Harry Hines Blvd Medical Staff Services, Dallas TX 75235-7708. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Women's Health, which is considered as her primary health care specialty. Bacon, Annette L. can be contacted via phone (214) 590-8006.

Contact Information

Primary practice address
5201 Harry Hines Blvd Medical Staff Services Dallas TX 75235-7708
Phone: (214) 590-8006
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X 530649 Texas

Profile Details

NPI number 1366506362
LBN Legal business name Bacon, Annette L.
Credentials WHCNP
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 21st, 2006
Last updated Feb 19th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366506362 NPPES
Texas MEDICAID 157515101
Texas MEDICAID 157515111
Texas MEDICAID 157515107
Texas Other 8Y1538
Texas MEDICAID 157515106
Texas MEDICAID 157515103
Texas MEDICAID 157515102
Texas MEDICAID 157515104
Texas MEDICAID 157515105
Texas MEDICAID 157515108
Texas MEDICAID 157515109
Texas MEDICAID 157515110

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