Organization
DIAGNOSTIC GROUP IMAGING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD THIBODAUX (CHIEF DATA OFFICER)
(409) 730-2022
Entity
Organization
Contact information
Practice address
3480 COLLEGE ST, SUITE 200, BEAUMONT, TX 77701
(409) 813-1677
(409) 813-1699
Mailing address
3406 COLLEGE ST, SUITE 200, BEAUMONT, TX 77701-4612
(409) 813-1677
(409) 813-1699
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
06/06/2015
Last updated
07/30/2018
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