Provider Demographics
NPI:1912867094
Name:BAYLOR SCOTT & WHITE HEALTHCARE HTPN
Entity type:Organization
Organization Name:BAYLOR SCOTT & WHITE HEALTHCARE HTPN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-912-9740
Mailing Address - Street 1:BAYLOR SCOTT & WHITE
Mailing Address - Street 2:740 N US HIGHWAY 377
Mailing Address - City:ROANOKE
Mailing Address - State:TX
Mailing Address - Zip Code:76262
Mailing Address - Country:US
Mailing Address - Phone:817-912-9740
Mailing Address - Fax:
Practice Address - Street 1:BAYLOR SCOTT & WHITE HEALTHCARE
Practice Address - Street 2:740 N US 377
Practice Address - City:ROANOKE
Practice Address - State:TX
Practice Address - Zip Code:76262
Practice Address - Country:US
Practice Address - Phone:817-912-9740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-12
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Single Specialty
No261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic