Provider Demographics
NPI:1497076145
Name:CLARUS IMAGING (BAYTOWN) LP
Entity Type:Organization
Organization Name:CLARUS IMAGING (BAYTOWN) LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:HERRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-981-5500
Mailing Address - Street 1:1455 MANOR DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-2271
Mailing Address - Country:US
Mailing Address - Phone:281-837-7600
Mailing Address - Fax:281-837-7601
Practice Address - Street 1:1455 MANOR DR
Practice Address - Street 2:SUITE 100
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-2271
Practice Address - Country:US
Practice Address - Phone:281-837-7600
Practice Address - Fax:281-837-7601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-17
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0773DCOtherBCBS