MEDICARE: BAYLEN DIAGNOSTIC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	2471C3401X	Computed Tomography Radiologic Technologist
2	2471S1302X	Sonography Radiologic Technologist
3	2471M1202X	Magnetic Resonance Imaging Radiologic Technologist

General Provider Information

NPI Number	:	1598917916
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAYLEN DIAGNOSTIC LLC

Provider Business Mailing Address
First Line	:	PO BOX 25943
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73125-0943
Country	:	US
Telephone Number	:	972-479-1115
Fax Number	:	972-479-1118

Provider Business Practice Location Address
First Line	:	5920 FOREST PARK RD
Second Line	:	SUITE 560
City	:	DALLAS
State	:	TX
Zip	:	75235-6411
Country	:	US
Telephone Number	:	214-350-0708
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF BILLING
Name	:	BARBARA LEHR
Credential	:
Telephone Number	:	972-479-1115

Provider Enumeration Date	:	10/16/2008
Last Update Date	:	10/16/2008

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Directions to “BAYLEN DIAGNOSTIC LLC ” Practice Location

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