Provider Demographics
NPI:1750380507
Name:BAYLOR MEDICAL CENTER AT WAXAHACHIE
Entity type:Organization
Organization Name:BAYLOR MEDICAL CENTER AT WAXAHACHIE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-843-4004
Mailing Address - Street 1:PO BOX 844597
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4597
Mailing Address - Country:US
Mailing Address - Phone:214-820-6710
Mailing Address - Fax:214-820-7950
Practice Address - Street 1:1405 W JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-2231
Practice Address - Country:US
Practice Address - Phone:972-923-8056
Practice Address - Fax:972-923-7096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-14
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000285332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3825810001OtherDME #