Organization
PROFESSIONAL IMAGING, PLLC
Active
Organization
PROFESSIONAL IMAGING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BEN LOUIS BAUMER (ACCOUNT MANAGER)
(281) 272-6277
Entity
Organization
Contact information
Practice address
1717 ROTARY DR, HUMBLE, TX 77338-5235
(866) 676-6277
(281) 272-6281
Mailing address
6078 BRIDGEVIEW DR, VENTURA, CA 93003-1126
(805) 293-1573
(805) 275-1842
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007115656
AETNA
TX
01
—
0073ML
BC/BS OF TEXAS
TX
05
—
172298501
—
TX
01
—
DD1023
RAILROAD MEDICARE
TX
Enumeration date
07/02/2006
Last updated
02/06/2023
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