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General NPI Number Information
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NPI Number | 1174717334
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL IMAGAING, LLC
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Dates
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Enumeration Date | 08/30/2007
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Last Update Date | 08/30/2007
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Provider Practice Location Address
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Address Line | 507 N SAM HOUSTON PKWY E SUITE 245
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City | HOUSTON
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State | TX
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Zip | 77060-4021
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Country | US
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Telephone | 281-272-6277
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Fax |
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Provider Business Mailing Address
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Address Line | 507 N SAM HOUSTON PKWY E SUITE 245
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City | HOUSTON
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State | TX
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Zip | 77060-4021
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Country | US
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Telephone | 281-272-6277
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Fax |
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Authorized Official
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Title or Position | TREASURER/BOM
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Name | MR. BEN L BAUMER
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Credential |
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Telephone | 805-275-1834
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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