Healthcare Provider Details

I. General information

NPI: 1124804687
Provider Name (Legal Business Name): BAYTOWN IMAGING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2023
Last Update Date: 09/07/2023
Certification Date: 09/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 GARTH RD
BAYTOWN TX
77521-3947
US

IV. Provider business mailing address

2800 GARTH RD
BAYTOWN TX
77521-3947
US

V. Phone/Fax

Practice location:
  • Phone: 832-667-8132
  • Fax:
Mailing address:
  • Phone: 832-667-8132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RAHUL DHAWAN
Title or Position: PRESIDENT
Credential:
Phone: 832-667-8132