Active NPI
Don Eugene Baccus, LPC
- Professional Counselor
- Pantego, TX
National Provider Identifier
1669961389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 74935
- Practice address
- 3603 W Pioneer Pkwy Ste a
Pantego, TX 76013-4535 - Phone
- (214) 875-0883
- Fax
- (972) 224-7001
- NPI assigned
- May 8, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 74935 | TX | Primary |
Addresses
Primary practice location
3603 W Pioneer Pkwy Ste a
Pantego, TX 76013-4535
Mailing address
1004 Cloverdale LN
Desoto, TX 75115-4106
Phone (214) 875-0883
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74935 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525737600000",
"number": "1669961389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1004 CLOVERDALE LN",
"city": "DESOTO",
"state": "TX",
"postal_code": "751154106",
"telephone_number": "214-875-0883",
"fax_number": "972-224-7001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3603 W PIONEER PKWY STE A",
"city": "PANTEGO",
"state": "TX",
"postal_code": "760134535",
"telephone_number": "214-875-0883",
"fax_number": "972-224-7001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACCUS",
"first_name": "DON",
"middle_name": "EUGENE",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-05-08",
"last_updated": "2018-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "74935",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pantego, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.