1649273434 NPI number — BAYLOR REGIONAL MEDICAL CENTER AT PLANO

Table of content: (NPI 1649273434)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649273434 NPI number — BAYLOR REGIONAL MEDICAL CENTER AT PLANO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BAYLOR REGIONAL MEDICAL CENTER AT PLANO
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:
1649273434
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 849829
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75284-9829
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-820-6710
Provider Business Mailing Address Fax Number:
214-820-7950

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4700 ALLIANCE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLANO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75093-5323
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
469-814-2000
Provider Business Practice Location Address Fax Number:
469-814-2999
Provider Enumeration Date:
05/24/2005

Additional Information

Authorized Official

Authorized Official Last Name:
GARISON
Authorized Official First Name:
JERRI
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
469-814-3176

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  008140 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 171848801 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 284511 . This is a "AMERICAID" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com