Provider Demographics
NPI:1659639722
Name:BAYLOR COLLEGE OF MEDICINE
Entity Type:Organization
Organization Name:BAYLOR COLLEGE OF MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ABDULLAH
Authorized Official - Middle Name:MOHAMMED
Authorized Official - Last Name:BASNAWI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-732-1523
Mailing Address - Street 1:1504 TAUB LOOP
Mailing Address - Street 2:EMERGENCY CENTER , C/O VICTORIA GARCIA
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1608
Mailing Address - Country:US
Mailing Address - Phone:713-873-7045
Mailing Address - Fax:
Practice Address - Street 1:1504 TAUB LOOP
Practice Address - Street 2:EMERGENCY CENTER , C/O VICTORIA GARCIA
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1608
Practice Address - Country:US
Practice Address - Phone:713-873-7045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-26
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10044220282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX566943OtherPHYSICIAN IN TRAINING BASIC POSTGRADUATE TRAINING PERMIT