Provider Demographics
NPI:1164763850
Name:BAYLOR MEDICAL CENTER AT WAXAHACHIE
Entity Type:Organization
Organization Name:BAYLOR MEDICAL CENTER AT WAXAHACHIE
Other - Org Name:IMAGING & DIAGNOSTIC CENTER AT RED OAK
Other - Org Type:Doing Business As
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 1:305 E OVILLA RD
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75154-3833
Mailing Address - Country:US
Mailing Address - Phone:972-617-7731
Mailing Address - Fax:
Practice Address - Street 1:305 E OVILLA RD
Practice Address - Street 2:
Practice Address - City:RED OAK
Practice Address - State:TX
Practice Address - Zip Code:75154-3833
Practice Address - Country:US
Practice Address - Phone:972-617-7731
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
TXR00380261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology