NPIMap

Organization Active NPI

Baylor College of Medicine

  • Dermatology Physician
  • Houston, TX
National Provider Identifier
1629082292
Registry record updated Feb 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
BAYLOR COLLEGE OF MEDICINE
Practice address
1977 Butler Blvd
Ste 1425
Houston, TX 77030-4101
Phone
(713) 798-6131
Fax
(713) 798-5535
NPI assigned
Jul 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2013

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

Authorized official

Name
Mr. Richard C Allison III
Title
Executive Director
Phone
(713) 798-1746

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

1977 Butler Blvd
Ste 1425
Houston, TX 77030-4101

Mailing address

2 E Greenway PLZ
Suite 900
Houston, TX 77046-0297
Phone (713) 798-6131

Other identifiers 1

IdentifierTypeStateIssuer
136324401MedicaidTX

Other names 1

  • Baylor Dermatology Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031106000562 TX Part B Supplier - Clinic/Group Practice 8224941265 Receives reassigned benefits from 2,374 practitioners
46 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Houston, TX; Pasadena, TX; Baytown, TX; Bellaire, TX; Galena Park, TX

Other NPIs on the same Medicare enrollment 46

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

View all 46

National Provider Directory

National Provider Directory

Member organizations 20

Organizations listed as members of this organization in the National Provider Directory.

View all 20

Locations

1977 Butler Blvd
Ste 1425
Houston, TX 77030
Phone (713) 798-6131

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360108800000",
    "number": "1629082292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 E GREENWAY PLZ",
            "address_2": "SUITE 900",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770460297",
            "telephone_number": "713-798-6131",
            "fax_number": "713-798-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1977 BUTLER BLVD",
            "address_2": "STE 1425",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304101",
            "telephone_number": "713-798-6131",
            "fax_number": "713-798-5535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYLOR COLLEGE OF MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2013-02-06",
        "status": "A",
        "authorized_official_last_name": "ALLISON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "713-798-1746",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136324401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baylor Dermatology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2013; 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.