Provider Demographics
NPI:1790298388
Name:BAYLOR ALL SAINTS MEDICAL CENTER
Entity Type:Organization
Organization Name:BAYLOR ALL SAINTS MEDICAL CENTER
Other - Org Name:BAS HOUSE PROVIDERS
Other - Org Type:Other Name
Authorized Official - Title/Position:VP OF FINANCE, WEST REGION CFO
Authorized Official - Prefix:
Authorized Official - First Name:LUCY
Authorized Official - Middle Name:
Authorized Official - Last Name:CATALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-922-1957
Mailing Address - Street 1:1400 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-4110
Mailing Address - Country:US
Mailing Address - Phone:817-922-1535
Mailing Address - Fax:817-927-6226
Practice Address - Street 1:1400 8TH AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4110
Practice Address - Country:US
Practice Address - Phone:817-922-1535
Practice Address - Fax:817-927-6226
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAYLOR ALL SAINTS MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-06
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGroup - Multi-Specialty