Provider Demographics
NPI:1053319798
Name:BAYLOR SPECIALTY HEALTH CENTERS
Entity Type:Organization
Organization Name:BAYLOR SPECIALTY HEALTH CENTERS
Other - Org Name:OUR CHILDREN'S HOUSE AT BAYLOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, GOVERNMENTAL FINANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:GALINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-215-9063
Mailing Address - Street 1:PO BOX 847137
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-7137
Mailing Address - Country:US
Mailing Address - Phone:214-820-6710
Mailing Address - Fax:214-820-7950
Practice Address - Street 1:3301 SWISS AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-6224
Practice Address - Country:US
Practice Address - Phone:214-820-9743
Practice Address - Fax:214-820-1490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000710261QA1903X, 282NC2000X, 283XC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No283XC2000XHospitalsRehabilitation HospitalChildren
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX094357302Medicaid
TX453308Medicare Oscar/Certification