MEDICARE: BAYLOR REGIONAL MEDICAL CENTER AT GRAPEVINE

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1902735020
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAYLOR REGIONAL MEDICAL CENTER AT GRAPEVINE

Provider Business Mailing Address
First Line	:	PO BOX 847229
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-7229
Country	:	US
Telephone Number	:	800-994-0371
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 W COLLEGE ST
Second Line	:
City	:	GRAPEVINE
State	:	TX
Zip	:	76051-3565
Country	:	US
Telephone Number	:	817-329-2500
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NAMAN MAHAJAN
Credential	:
Telephone Number	:	832-962-0487

Provider Enumeration Date	:	05/15/2026
Last Update Date	:	05/15/2026

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