Active NPI
Walter M Bain, MD
- Otolaryngology Physician
- San Antonio, TX
National Provider Identifier
1194890863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- E4184
- Practice address
- 1303 McCullough Ave
Ste 242
San Antonio, TX 78212-5604 - Phone
- (210) 226-8982
- Fax
- (210) 227-1736
- NPI assigned
- Nov 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | E4184 | TX | Primary |
Addresses
Primary practice location
1303 McCullough Ave
Ste 242
San Antonio, TX 78212-5604
Mailing address
1303 McCullough Ave
Ste 242
San Antonio, TX 78212-5604
Phone (210) 226-8982
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 742630478 | Other | CHAMPUS | |
| 082977201 | Medicaid | TX | |
| 86M432 | Other | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walter M. Bain MD PA | Otolaryngology | Current | Accepting new patients |
| Ear Institute of Texas P a | Otolaryngology | Current | Accepting new patients |
Locations
1303 McCullough Ave
Ste 242
San Antonio, TX 78212
Phone (210) 226-8982
18518 Hardy Oak Blvd
Ste 300
San Antonio, TX 78258
Phone (210) 696-4327
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277769600000",
"number": "1194890863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1303 MCCULLOUGH AVE",
"address_2": "STE 242",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782125604",
"telephone_number": "210-226-8982",
"fax_number": "210-227-1736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1303 MCCULLOUGH AVE",
"address_2": "STE 242",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782125604",
"telephone_number": "210-226-8982",
"fax_number": "210-227-1736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAIN",
"first_name": "WALTER",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-21",
"last_updated": "2010-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "TX",
"license": "E4184",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "742630478",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "082977201",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "86M432",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.