Edgar Quinagoran Bacud, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1072247 Issued in TX

Practice address

4206 South Fitzhugh Avenue
Dallas, TX 75210

Phone

(214) 926-5319

Fax

(972) 412-4603

NPI assigned

Aug 20, 2008

Last updated

Nov 12, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Northeast Healthcare Services Inc.

  dba N/a

  • Home Health Agency
  • Sachse, TX
  • NPI 1043542178
  NPD (past)

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

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289520000000",
    "number": "1962659086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9710 BROADMOOR LANE",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "75089",
            "telephone_number": "214-206-6086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4206 SOUTH FITZHUGH AVENUE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75210",
            "telephone_number": "214-926-5319",
            "fax_number": "972-412-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACUD",
        "first_name": "EDGAR",
        "middle_name": "QUINAGORAN",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-20",
        "last_updated": "2010-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1072247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TXB104213",
            "identifier": "TXB104213",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Annette L. Bacon, WHCNP
• Boone Bacon, PA-C
• Rebecca Gray Bacsik, L.M.F.T.
• Susan L Bacsik, D.O.
• Chasta-Dawne Louise Bacsu, M.D.
• Winona Bacud
• Sarah McMenamin Baculi
• Alexa Jo Badalamenti, MS
• Arshia Badani, DMD
• Wali Badar, MD.MS

• Physical Therapist in Dallas, TX
• Providers in Dallas, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.

Verify at the official NPI Registry.