Provider Demographics
NPI:1659659118
Name:BAYLOR COLLEGE OF MEDICINE
Entity Type:Organization
Organization Name:BAYLOR COLLEGE OF MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROF
Authorized Official - Prefix:PROF
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KOCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-240-4564
Mailing Address - Street 1:3 HERMANN MUSEUM CIRCLE DR
Mailing Address - Street 2:2315
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-7788
Mailing Address - Country:US
Mailing Address - Phone:832-231-6661
Mailing Address - Fax:
Practice Address - Street 1:6565 FANNIN ST
Practice Address - Street 2:NC-205
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2703
Practice Address - Country:US
Practice Address - Phone:713-798-5913
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10039756284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital