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1205813052
KENNETH TERRY BACON
AUSTIN, TX
NPI
1205813052
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2085R0202X Radiology, Diagnostic Radiology
(Licence: TX D5902)
Enumeration Date
2005-12-22
Last Update Date
2008-03-04
Business Address
-- KENNETH TERRY BACON MD
8038 MESA DR
AUSTIN, TX 78731-1319
Phone number: 512-901-8748
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Mailing Address
-- KENNETH TERRY BACON MD
12221 MOPAC EXPRESSWAY NORTH
AUSTIN, TX 78758-2483
Phone number: 512-901-8748
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