Baylor College of Medicine

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

511846 Issued in TX

Legal business name

BAYLOR COLLEGE OF MEDICINE

Practice address

1709 Dryden Rd
750
Houston, TX 77030-2400

Phone

(713) 798-4696

Fax

(713) 798-3739

NPI assigned

May 27, 2008

Last updated

May 27, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Coreen Von Fazakerly, MSN, ANP-CNPI 1871717942

Title

Nurse Practitioner

Phone

(713) 798-4696

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Coreen Von Fazakerly, NP

  • Nurse Practitioner
  • Houston, TX
  • NPI 1871717942
  Authorized official Same address or phone

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211846400000",
    "number": "1841458965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5012 JACKWOOD ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770961507",
            "telephone_number": "713-664-8862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 DRYDEN RD",
            "address_2": "750",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302400",
            "telephone_number": "713-798-4696",
            "fax_number": "713-798-3739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYLOR COLLEGE OF MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-27",
        "last_updated": "2008-05-27",
        "status": "A",
        "authorized_official_last_name": "FAZAKERLY",
        "authorized_official_first_name": "COREEN",
        "authorized_official_middle_name": "VON",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "713-798-4696",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSN, ANP-C"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "511846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Baylor College of Medicine
• Baylor College of Medicine (BCM Physicians)
• Baylor College of Medicine
• Baylor College of Medicine
• Baylor College of Medicine (BCM - Urgent Care)
• Baylor College of Medicine
• Baylor College of Medicine (HCHD Geriatrics)
• Baylor College of Medicine (BCM Physicians)
• Baylor College of Medicine
• Baylor College of Medicine (AMS Baylor - HCHD Hematology)

• Ambulatory Surgical Clinic/Center in Houston, TX
• Providers in Houston, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.