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General NPI Number Information
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NPI Number | 1780026443
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Entity Type | Organization
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Legal Business Name | BAYTOWN GERIATRICS, P.A.
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Dates
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Enumeration Date | 07/23/2013
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Last Update Date | 07/23/2013
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Provider Practice Location Address
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Address Line | 4110 AVALON LN
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City | BAYTOWN
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State | TX
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Zip | 77521-2867
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Country | US
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Telephone | 281-384-6286
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Fax | 281-421-0948
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Provider Business Mailing Address
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Address Line | PO BOX 507
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City | BAYTOWN
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State | TX
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Zip | 77522-0507
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Country | US
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Telephone | 281-384-6286
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Fax | 281-421-0948
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Authorized Official
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Title or Position | PRESIDENT/SECRETARY
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Name | RICHARD WAYNE DEMMLER
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Credential | M.D.
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Telephone | 281-384-6286
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | E8431
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License Number State | TX
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