Provider Demographics
NPI:1417130394
Name:BAY CITY IMAGING INC
Entity Type:Organization
Organization Name:BAY CITY IMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-419-9221
Mailing Address - Street 1:PO BOX 306365
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6365
Mailing Address - Country:US
Mailing Address - Phone:800-249-3478
Mailing Address - Fax:713-592-6772
Practice Address - Street 1:720 AVENUE F N
Practice Address - Street 2:SUITE 1
Practice Address - City:BAY CITY
Practice Address - State:TX
Practice Address - Zip Code:77414-9573
Practice Address - Country:US
Practice Address - Phone:979-323-9797
Practice Address - Fax:979-323-0767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-13
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiologyGroup - Multi-Specialty
No261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)Group - Multi-Specialty
No293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX201633901Medicaid
TXC17981Medicare UPIN
TX201633901Medicaid