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DSH450021A BAYLOR UNIVERSITY MEDICAL CENTER (Terminated)
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Main Details
Name
BAYLOR UNIVERSITY MEDICAL CENTER
Subdivision Name
Weight Loss Surgery Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450021A
Medicare Provider Number
450021
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/15/2013
Participating Start Date
1/1/2014
Participating Approval Date
11/3/2013
Last Recertification Date
8/19/2016
Termination Date
Termination Reason
4/1/2017
DSH percentage below statutory minimum
Contacts
Authorizing Official
Douglas T. Lawson, PRESIDENT
(214) 820-3101
Primary Contact
Kirk Starr, Director of Pharmacy
(214) 820-2968
Addresses
Street Address
9101 N. Central Expressway
Suite 370
Dallas, TX 75246
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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