Provider Demographics
NPI:1275874521
Name:BAYLOR ALL SAINTS MEDICAL CENTER
Entity Type:Organization
Organization Name:BAYLOR ALL SAINTS MEDICAL CENTER
Other - Org Name:BAYLOR ALL SAINTS OUTPATIENT DIAGNOSTIC CENTER
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 1:1701 W ROSEDALE ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-7425
Mailing Address - Country:US
Mailing Address - Phone:817-922-7780
Mailing Address - Fax:
Practice Address - Street 1:1701 W ROSEDALE ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-7425
Practice Address - Country:US
Practice Address - Phone:817-922-7780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR00492261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology