Basic Information
| Provider Information | |||||||||
| NPI: | 1760092035 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BABYLON HEALTHCARE INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2500 BEE CAVES RD. | ||||||||
| Address2: | BLDG 1 STE 400 | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787465888 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8004756168 | ||||||||
| FaxNumber: | 8559431026 | ||||||||
| Practice Location | |||||||||
| Address1: | 2500 BEE CAVES RD. | ||||||||
| Address2: | BLDG 1 STE 400 | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787465888 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8004756168 | ||||||||
| FaxNumber: | 8559431026 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2020 | ||||||||
| LastUpdateDate: | 04/06/2022 | ||||||||
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| AuthorizedOfficialLastName: | CHEN | ||||||||
| AuthorizedOfficialFirstName: | STEPHEN | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | LEGAL COUNSEL | ||||||||
| AuthorizedOfficialTelephone: | 8004756168 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 04/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | 207Q00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 500088458 | 05 | MO | MEDICAID | 830087914 | 05 | MO | MEDICAID |