Provider Demographics
NPI:1003134024
Name:DIAGNOSTEX CONSULTANTS PLLC
Entity Type:Organization
Organization Name:DIAGNOSTEX CONSULTANTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:BAUMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-514-6271
Mailing Address - Street 1:500 GRAPEVINE HWY
Mailing Address - Street 2:STE. 106
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-2707
Mailing Address - Country:US
Mailing Address - Phone:817-514-6271
Mailing Address - Fax:817-514-6278
Practice Address - Street 1:500 GRAPEVINE HWY
Practice Address - Street 2:STE. 106
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-2707
Practice Address - Country:US
Practice Address - Phone:817-514-6271
Practice Address - Fax:817-514-6278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-14
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2187599301Medicaid
TXTXB1003134024Medicare PIN