1558694562 NPI number — BAYLOR COLLEGE OF MEDICINE

Table of content: (NPI 1558694562)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558694562 NPI number — BAYLOR COLLEGE OF MEDICINE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BAYLOR COLLEGE OF MEDICINE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
OCCUPATIONAL MEDICINE
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558694562
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/09/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 GREENWAY PLZ
Provider Second Line Business Mailing Address:
SUITE 900
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77046-0297
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-798-1750
Provider Business Mailing Address Fax Number:
713-798-1144

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6620 MAIN ST
Provider Second Line Business Practice Location Address:
SUITE 1375
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77030-2348
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-798-7880
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/09/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SIMMONS
Authorized Official First Name:
AMANDA
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
713-798-1750

Provider Taxonomy Codes

  • Taxonomy code: 261QX0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)