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General NPI Number Information
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NPI Number | 1730024704
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Entity Type | Organization
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Legal Business Name | BAYTOWN EMERGENCY PHYSICIAN GROUP, PLLC
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Dates
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Enumeration Date | 04/23/2026
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Last Update Date | 04/23/2026
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Provider Practice Location Address
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Address Line | 1404 W BAKER RD
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City | BAYTOWN
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State | TX
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Zip | 77521-2140
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Country | US
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Telephone | 281-628-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 MAIN ST #368 C/O DEER PARK PHYSICIAN GROUP
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City | SEABROOK
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State | TX
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Zip | 77586-9998
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Country | US
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Telephone | 832-541-8155
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. RADHESHYAM MIRYALA
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Credential | MD
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Telephone | 832-541-8155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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