Provider Demographics
NPI:1447818877
Name:QUINTANAR, BAILEY (PT, DPT)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:
Last Name:QUINTANAR
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 PITTSBURG ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75207-7207
Mailing Address - Country:US
Mailing Address - Phone:785-456-3321
Mailing Address - Fax:
Practice Address - Street 1:119 PITTSBURG ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75207-7207
Practice Address - Country:US
Practice Address - Phone:785-456-3321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-31
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1318307208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1318307OtherPT LICENSE NUMBER