MEDICARE: BAYLOR MEDICAL CENTER AT GARLAND

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	261QR0200X	Radiology Clinic/Center	000027	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00043793	OTHER		RAILROAD PROVIDER #

General Provider Information

NPI Number	:	1972589620
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAYLOR MEDICAL CENTER AT GARLAND

Provider Business Mailing Address
First Line	:	PO BOX 841540
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-1540
Country	:	US
Telephone Number	:	214-820-6710
Fax Number	:	214-820-7950

Provider Business Practice Location Address
First Line	:	2300 MARIE CURIE DRIVE
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75042
Country	:	US
Telephone Number	:	972-487-5358
Fax Number	:	972-487-5023

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MS. PAMELA BARNES
Credential	:
Telephone Number	:	214-820-7268

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	03/08/2011

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