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General NPI Number Information
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NPI Number | 1003813742
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Entity Type | Organization
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Legal Business Name | BAYLOR INSTITUTE FOR REHABILITATION AT GASTON EPISCOPAL HOSPITAL
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 09/29/2009
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Provider Practice Location Address
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Address Line | 909 N WASHINGTON AVE
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City | DALLAS
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State | TX
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Zip | 75246-1520
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Country | US
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Telephone | 214-820-9300
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Fax | 214-820-9295
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Provider Business Mailing Address
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Address Line | PO BOX 847093
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City | DALLAS
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State | TX
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Zip | 75284-7093
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Country | US
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Telephone | 214-820-1538
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Fax | 214-820-7950
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Authorized Official
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Title or Position | VICE PRESIDENT OF FINANCE
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Name | MS. CHERYL D MCMULLAN
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Credential |
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Telephone | 214-820-9505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283X00000X
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Taxonomy Name | Rehabilitation Hospital
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License Number | 000642
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License Number State | TX
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