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General NPI Number Information
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NPI Number | 1346205093
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Entity Type | Organization
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Legal Business Name | SOUTHEAST TEXAS IMAGING LLP
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Dates
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Enumeration Date | 04/18/2006
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 2830 CALDER ST
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City | BEAUMONT
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State | TX
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Zip | 77702-1809
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Country | US
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Telephone | 409-892-7171
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Fax |
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Provider Business Mailing Address
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Address Line | 709 LITTLE JEFF DR
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City | PORT NECHES
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State | TX
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Zip | 77651-4822
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Country | US
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Telephone | 409-729-5400
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Fax | 409-729-4850
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSEPH A NIGHTINGALE
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Credential | MD
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Telephone | 409-729-5400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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