MEDICARE: BAYLOR COLLEG OF MEDICINE TEEN HEALTH CLINIC

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	261QA0005X	Ambulatory Family Planning Facility
2	261QF0050X	Non-Surgical Family Planning Clinic/Center

General Provider Information

NPI Number	:	1457480212
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAYLOR COLLEG OF MEDICINE TEEN HEALTH CLINIC

Provider Business Mailing Address
First Line	:	1504 TAUB LOOP
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-1608
Country	:	US
Telephone Number	:	713-873-3601
Fax Number	:	713-873-3608

Provider Business Practice Location Address
First Line	:	5737 CULLEN BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77021-1638
Country	:	US
Telephone Number	:	713-440-7313
Fax Number	:	713-440-8358

Authorized Official
Title or Position	:	PROFESSOR DIRECTOR
Name	:	PROF. PEGGY B. SMITH
Credential	:	PHD.
Telephone Number	:	713-873-3601

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	09/11/2025

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