Healthcare Provider Details

I. General information

NPI: 1902735020
Provider Name (Legal Business Name): BAYLOR REGIONAL MEDICAL CENTER AT GRAPEVINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 W COLLEGE ST
GRAPEVINE TX
76051-3565
US

IV. Provider business mailing address

PO BOX 847229
DALLAS TX
75284-7229
US

V. Phone/Fax

Practice location:
  • Phone: 817-329-2500
  • Fax:
Mailing address:
  • Phone: 800-994-0371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: NAMAN MAHAJAN
Title or Position: PRESIDENT
Credential:
Phone: 832-962-0487