MEDICARE: BAYLOR COLLEGE OF MEDICINE

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1720305543
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAYLOR COLLEGE OF MEDICINE

Provider Business Mailing Address
First Line	:	1800 EL PASEO ST
Second Line	:	APT NO 113
City	:	HOUSTON
State	:	TX
Zip	:	77054-3053
Country	:	US
Telephone Number	:	281-772-1442
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 EL PASEO ST
Second Line	:	APT NO 113
City	:	HOUSTON
State	:	TX
Zip	:	77054-3053
Country	:	US
Telephone Number	:	281-772-1442
Fax Number	:

Authorized Official
Title or Position	:	RESIDENT
Name	:	DR. KASHAN KHALID
Credential	:	M.D
Telephone Number	:	281-772-1442

Provider Enumeration Date	:	05/03/2010
Last Update Date	:	05/03/2010

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