KENNETH TERRY BACON MD NPI 1205813052

NPI Information

  • NPI: 1205813052
  • Provider Name: KENNETH TERRY BACON, MD
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Individual
  • Address: 8038 MESA DR
    AUSTIN, TX
    ZIP 78731
  • Phone: (512) 901-8748

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NPI Details

Kenneth Terry Bacon, MD is a diagnostic radiology radiology in Austin, TX. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Kenneth Terry Bacon, MD NPI is 1205813052. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

8038 MESA DR
AUSTIN, TX
ZIP 78731-319
Phone: (512) 901-8748

The enumeration date for this NPI number is 12/22/2005 and was last updated on 3/4/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic RadiologyD5902TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
182R046MEDICARE PINTEXAS
2D47879MEDICARE UPINTEXAS
3P00433569MEDICARE PINTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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