David Jacob Bauder, PA-C

Individual provider Active NPI Medical Physician Assistant · Fort Hood, TX

NPI 1477619476 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1477619476
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
Practice address
BLDG 2245 Thomas Moore Health Clinic
58TH Street and 761St Tank Battalion Ave
Fort Hood, TX 76544
Phone
(254) 287-4943
NPI assigned
Dec 28, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Weight Loss and Vitality, Inc Current
since Feb 1, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Yes

Addresses

Primary practice location

BLDG 2245 Thomas Moore Health Clinic
58TH Street and 761St Tank Battalion Ave
Fort Hood, TX 76544

Mailing address

12907 Vidorra Vista Dr
San Antonio, TX 78216-7761
Phone (210) 493-2137

Other providers in Fort Hood, TX

All providers in Fort Hood, TX · Medical Physician Assistant in Texas

Sources for this page

Verify at the official NPI Registry.