Provider Demographics
NPI:1609855139
Name:BAYLOR HEART & VASCULAR CENTER LLP
Entity Type:Organization
Organization Name:BAYLOR HEART & VASCULAR CENTER LLP
Other - Org Name:BAYLOR SCOTT & WHITE HEART AND VASCULAR HOSPITAL - DALLAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:VISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-820-0699
Mailing Address - Street 1:PO BOX 848076
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-8076
Mailing Address - Country:US
Mailing Address - Phone:214-820-6710
Mailing Address - Fax:214-820-7950
Practice Address - Street 1:621 N HALL ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75226-1339
Practice Address - Country:US
Practice Address - Phone:214-820-0670
Practice Address - Fax:214-820-0690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-12
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007844282N00000X, 284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No284300000XHospitalsSpecial Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX151691601Medicaid
TX45-0851Medicare Oscar/Certification