Provider Demographics
NPI:1235705674
Name:INFINITY DIAGNOSTICS CENTER BEAUMONT LLC
Entity Type:Organization
Organization Name:INFINITY DIAGNOSTICS CENTER BEAUMONT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:HATCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-333-1487
Mailing Address - Street 1:3310 EDLOE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-6502
Mailing Address - Country:US
Mailing Address - Phone:713-396-7066
Mailing Address - Fax:713-396-7067
Practice Address - Street 1:5755 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77707-3518
Practice Address - Country:US
Practice Address - Phone:409-333-1487
Practice Address - Fax:713-396-7067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)