=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245407287
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BAYLOR COLLEGE OF MEDICINE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/09/2008
-----------------------------------------------------
Last Update Date | 05/09/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 BAYLOR PLZ
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77030-3411
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-798-4401
-----------------------------------------------------
Fax | 713-798-6633
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 BAYLOR PLZ
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77030-3411
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT AND CEO
-----------------------------------------------------
Name | DR. PETER TRABE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 713-798-1297
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 293D00000X
-----------------------------------------------------
Taxonomy Name | Physiological Laboratory
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------