Provider Demographics
NPI:1023442480
Name:BAYLOR SCOTT & WHITE HEALTH ENTERPRISES, INC.
Entity type:Organization
Organization Name:BAYLOR SCOTT & WHITE HEALTH ENTERPRISES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-865-3669
Mailing Address - Street 1:PO BOX 847670
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-7670
Mailing Address - Country:US
Mailing Address - Phone:972-579-4074
Mailing Address - Fax:972-579-3987
Practice Address - Street 1:1901 N MACARTHUR BLVD
Practice Address - Street 2:SUITE 1001
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-2220
Practice Address - Country:US
Practice Address - Phone:972-579-4074
Practice Address - Fax:972-579-3987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-21
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX287343336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2140932OtherPK
TX470148Medicaid