Provider Demographics
NPI:1568664464
Name:BAYLOR, BEULAH L (LICENSE NURSE)
Entity Type:Individual
Prefix:MS
First Name:BEULAH
Middle Name:L
Last Name:BAYLOR
Suffix:
Gender:F
Credentials:LICENSE NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14220 PARK ROW
Mailing Address - Street 2:APT 1022
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-5190
Mailing Address - Country:US
Mailing Address - Phone:281-596-8683
Mailing Address - Fax:832-550-2893
Practice Address - Street 1:14220 PARK ROW
Practice Address - Street 2:APT 1022
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-5190
Practice Address - Country:US
Practice Address - Phone:281-596-8683
Practice Address - Fax:832-550-2893
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX132141164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse