Provider Demographics
NPI:1801262241
Name:BAYLOR SCOTT AND WHITE
Entity type:Organization
Organization Name:BAYLOR SCOTT AND WHITE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGION REHAB DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:COWAN
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:830-201-7131
Mailing Address - Street 1:800 W HIGHWAY 71
Mailing Address - Street 2:
Mailing Address - City:MARBLE FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:78654-8606
Mailing Address - Country:US
Mailing Address - Phone:830-201-7131
Mailing Address - Fax:
Practice Address - Street 1:800 W HIGHWAY 71
Practice Address - Street 2:
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-8606
Practice Address - Country:US
Practice Address - Phone:830-201-7131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-20
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1053460261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy