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General NPI Number Information
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NPI Number | 1124492756
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Entity Type | Organization
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Legal Business Name | BAYLOR COLLEGE OF MEDICINE
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Dates
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Enumeration Date | 11/19/2015
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Last Update Date | 11/19/2015
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Provider Practice Location Address
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Address Line | 12301 MAIN ST
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City | HOUSTON
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State | TX
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Zip | 77035-6207
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Country | US
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Telephone | 713-275-5000
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Fax | 713-275-5107
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Provider Business Mailing Address
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Address Line | 12301 MAIN ST
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City | HOUSTON
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State | TX
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Zip | 77035-6207
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Country | US
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Telephone | 713-275-5000
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Fax | 713-275-5107
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Authorized Official
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Title or Position | DIVISION DIRECTOR
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Name | DR. FLYNN O'MALLEY
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Credential | PH.D.
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Telephone | 274-713-5289
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 36111
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License Number State | TX
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