Robert J Bacon Jr., MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

F0861 Issued in TX

Practice address

1919 North Loop W Ste 224
Houston, TX 77008-1366

Phone

(713) 655-9410

Fax

(713) 869-4506

NPI assigned

Nov 22, 2006

Last updated

Jul 8, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Meharry Medical College School of Medicine, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• North Houston Imaging Center,LTD

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Houston, TX
  • NPI 1093954547
  Medicare reassignment
• Alphamed Healthcare Systems

  • Counselor
  • Houston, TX
  • NPI 1376754812
  NPD (past)
• Courage to Change, Inc.

  • Community/Behavioral Health Agency
  • Houston, TX
  • NPI 1962632687

  Psychiatry

  NPD (past)
• R&JW,LLC

  • Mental Health Counselor
  • Houston, TX
  • NPI 1831487347
  NPD (past)
• Samantha J Vigneri

  dba Comprehensive Therapies and Services

  • Social Worker
  • Hempstead, TX
  • NPI 1073617684

  Psychiatry

  NPD (past)
• Southeast

  • Ambulance
  • Houston, TX
  • NPI 1205818150
  NPD (past)
• Southwest Community Clinic

  • General Practice Physician
  • Houston, TX
  • NPI 1275717720
  NPD (past)
• Vermon Earl Lacy III

  dba Turn Around Program

  • Clinical Social Worker
  • Houston, TX
  • NPI 1306174297
  NPD (past)
• Wilmar Healthcare Systems, Inc.

  • Psychologist
  • Houston, TX
  • NPI 1831287218
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1700951704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 NORTH LOOP W STE 224",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770081366",
            "telephone_number": "713-655-9410",
            "fax_number": "713-869-4506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 NORTH LOOP W STE 224",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770081366",
            "telephone_number": "713-655-9410",
            "fax_number": "713-869-4506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "ROBERT",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "F0861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137509904",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "260034924",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00117827",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137509907",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Bacolod, LPTA
• Alexis Victoria Bacon-Yates, MS., ED.
• Gayle Bacon, M.S., CCC-SLP
• Jessica Rose Ognian Bacon, LPC
• Katherine Marie Bacon, PH.D.
• Monique Gail Dela Cruz Bactad
• Shani Bacy
• Shadi Badan, M.D.
• Kausar T Badar, CNMT
• Tehmina Ahmed Badar, M.D.

• Psychiatry Physician in Houston, TX
• Providers in Houston, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.