1760912554 NPI number — BAYLOR SURGICARE AT BAYLOR PLANO, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760912554 NPI number — BAYLOR SURGICARE AT BAYLOR PLANO, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BAYLOR SURGICARE AT BAYLOR PLANO, LLC
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:
Provider Other Organization Name Type Code:
6
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:
1760912554
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/04/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4825 ALLIANCE BLVD STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLANO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75093-5504
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
469-367-0700
Provider Business Mailing Address Fax Number:
469-367-0770

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4825 ALLIANCE
Provider Second Line Business Practice Location Address:
SUTE 300
Provider Business Practice Location Address City Name:
PLANO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75093
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
469-367-0700
Provider Business Practice Location Address Fax Number:
469-367-0770
Provider Enumeration Date:
06/14/2017

Additional Information

Authorized Official

Authorized Official Last Name:
FLEMING
Authorized Official First Name:
DONITA
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICER / AUTHORIZED OFFICIAL
Authorized Official Telephone Number:
202-815-3665

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com