MEDICARE: BAYLOR UNIVERSITY MEDICAL CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	273R00000X	Psychiatric Hospital Unit	000331	TX

General Provider Information

NPI Number	:	1134129851
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAYLOR UNIVERSITY MEDICAL CENTER

Provider Business Mailing Address
First Line	:	PO BOX 842022
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-2022
Country	:	US
Telephone Number	:	214-820-6710
Fax Number	:	214-820-7950

Provider Business Practice Location Address
First Line	:	3500 GASTON AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75246-2017
Country	:	US
Telephone Number	:	214-820-1913
Fax Number	:	214-820-4283

Authorized Official
Title or Position	:	CEO
Name	:	STEVEN NEWTON
Credential	:
Telephone Number	:	214-820-3101

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	01/22/2020

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