Provider Demographics
NPI:1245626696
Name:BAYLOR COLLEGE OF MEDICINE
Entity type:Organization
Organization Name:BAYLOR COLLEGE OF MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, PRESIDENT, EXECUTIVE DEAN
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:KLOTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-798-4500
Mailing Address - Street 1:4812 TAMARISK ST
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2822
Mailing Address - Country:US
Mailing Address - Phone:832-677-4793
Mailing Address - Fax:
Practice Address - Street 1:1 BAYLOR PLZ
Practice Address - Street 2:BCM610
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3411
Practice Address - Country:US
Practice Address - Phone:832-826-7372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-13
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10052495207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty