# BAYSIDE RADIOLOGY AND IMAGING OF ROWLETT PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bayside Radiology and IMaging
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861961815
- **Authorized official:** BRAD BOEKE DDS (MEMBER)
- **Authorized official phone:** (972) 840-2020

## Contact information

- **Practice address:** 4624 LAKEVIEW PKWY, ROWLETT, TX 75088-4027
- **Practice address phone:** (972) 840-2020
- **Practice address fax:** (972) 694-0260
- **Mailing address:** 4624 LAKEVIEW PKWY, ROWLETT, TX 75088-4027
- **Mailing address phone:** (972) 840-2020
- **Mailing address fax:** (972) 694-0260

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 11/20/2018
- **Last updated:** 11/20/2018