Organization
FAIRMONT DIAGNOSTIC CENTER AND OPEN MRI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK LEE BAKER M.D. (OWNER)
(281) 487-6736
Entity
Organization
Contact information
Practice address
3692 E SAM HOUSTON PKWY S, PASADENA, TX 77505-3137
(281) 487-6736
(281) 487-3187
Mailing address
3692 E SAM HOUSTON PKWY S, PASADENA, TX 77505-3137
(281) 487-6736
(281) 487-3187
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
MDJ2489
TX
Other
Enumeration date
10/10/2006
Last updated
09/24/2008
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