Healthcare Provider Details

I. General information

NPI: 1194714659
Provider Name (Legal Business Name): BAYTOWN RADIOLOGY ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 05/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 GARTH RD
BAYTOWN TX
77521-2122
US

IV. Provider business mailing address

800 ROCKMEAD DR STE 210
KINGWOOD TX
77339
US

V. Phone/Fax

Practice location:
  • Phone: 281-359-7788
  • Fax: 281-359-7888
Mailing address:
  • Phone: 281-359-7788
  • Fax: 281-359-7888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: LUIS ALBUERNE
Title or Position: RADIOLOGIST
Credential: M.D.
Phone: 281-359-7788