NPIMap

Organization Active NPI

Baylor Scott & White Health Enterprises, Inc.

Doing business as Baylor Scott & White Pharmacy #202

  • Community/Retail Pharmacy
  • Georgetown, TX
National Provider Identifier
1003984071
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
29826 Issued in TX
Legal business name
BAYLOR SCOTT & WHITE HEALTH ENTERPRISES, INC.
Doing business as
Baylor Scott & White Pharmacy #202
Practice address
4945 Williams Dr
Georgetown, TX 78633-2008
Phone
(512) 942-3302
Fax
(512) 942-3304
NPI assigned
Nov 30, 2006
Last updated
Apr 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tammy Cohen
Title
President
Phone
(214) 865-3669

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 29826 TX Primary

Addresses

Primary practice location

4945 Williams Dr
Georgetown, TX 78633-2008

Mailing address

PO Box 847670
Dallas, TX 75284-5765
Phone (512) 942-3302

Other identifiers 2

IdentifierTypeStateIssuer
469765MedicaidTX
2151712OtherPK

Other names 1

  • Baylor Scott & White Pharmacy #202 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200819000208 TX Part B Supplier - Pharmacy 8426182049 31 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: McKinney, TX; Salado, TX; Pflugerville, TX; Round Rock, TX; Temple, TX; Waco, TX; Waxahachie, TX; Irving, TX…

Other NPIs on the same Medicare enrollment 27

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 27

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745452800000",
    "number": "1003984071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 847670",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845765",
            "telephone_number": "512-942-3302",
            "fax_number": "512-942-3304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4945 WILLIAMS DR",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786332008",
            "telephone_number": "512-942-3302",
            "fax_number": "512-942-3304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYLOR SCOTT & WHITE HEALTH ENTERPRISES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-865-3669"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "29826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "469765",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2151712",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baylor Scott & White Pharmacy #202",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Baylor Scott & White Pharmacy #202",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Georgetown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.