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
1	207N00000X	Dermatology Physician
2	207P00000X	Emergency Medicine Physician
3	207R00000X	Internal Medicine Physician
4	207W00000X	Ophthalmology Physician
5	208000000X	Pediatrics Physician
6	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1831655315
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAYLOR COLLEGE OF MEDICINE

Provider Business Mailing Address
First Line	:	2 GREENWAY PLZ STE 900
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77046-0205
Country	:	US
Telephone Number	:	713-798-1976
Fax Number	:	713-798-4693

Provider Business Practice Location Address
First Line	:	3743 WESTHEIMER RD STE A
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027-5227
Country	:	US
Telephone Number	:	713-798-1746
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	RICHARD ALLISON III
Credential	:
Telephone Number	:	713-798-1746

Provider Enumeration Date	:	02/20/2019
Last Update Date	:	04/23/2019

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