Provider Demographics
NPI:1528309135
Name:BAYLOR MEDICAL CENTER AT IRVING
Entity type:Organization
Organization Name:BAYLOR MEDICAL CENTER AT IRVING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-820-7808
Mailing Address - Street 1:2740 N STATE HIGHWAY 360
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-6403
Mailing Address - Country:US
Mailing Address - Phone:972-579-4480
Mailing Address - Fax:
Practice Address - Street 1:2740 N STATE HIGHWAY 360
Practice Address - Street 2:SUITE 200
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-6403
Practice Address - Country:US
Practice Address - Phone:972-579-4480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR00406261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology