NPIMap

Organization Active NPI

Baylor Scott & White Health Enterprises, Inc.

Doing business as Baylor Scott & White Pharmacy #107

  • Community/Retail Pharmacy
  • Grapevine, TX
National Provider Identifier
1487094389
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
28618 Issued in TX
Legal business name
BAYLOR SCOTT & WHITE HEALTH ENTERPRISES, INC.
Doing business as
Baylor Scott & White Pharmacy #107
Practice address
1600 W College St
Suite 110
Grapevine, TX 76051-3580
Phone
(817) 388-3090
Fax
(817) 388-3091
NPI assigned
Jun 25, 2013
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 28618 TX Primary

Addresses

Primary practice location

1600 W College St
Suite 110
Grapevine, TX 76051-3580

Mailing address

PO Box 847670
Dallas, TX 75284-7670
Phone (214) 820-9268

Other identifiers 2

IdentifierTypeStateIssuer
2140933OtherPK
469873MedicaidTX

Other names 1

  • Baylor Scott & White Pharmacy #107 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": "1372118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745452800000",
    "number": "1487094389",
    "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": "752847670",
            "telephone_number": "214-820-9268",
            "fax_number": "214-818-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W COLLEGE ST",
            "address_2": "SUITE 110",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513580",
            "telephone_number": "817-388-3090",
            "fax_number": "817-388-3091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYLOR SCOTT & WHITE HEALTH ENTERPRISES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-25",
        "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": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "28618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2140933",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "469873",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baylor Scott & White Pharmacy #107",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Baylor Scott & White Pharmacy #107",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grapevine, 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.