Provider Demographics
NPI:1861449894
Name:BAAXTEN, LLC
Entity Type:Organization
Organization Name:BAAXTEN, LLC
Other - Org Name:BAAXTEN IMAGING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAGDALENA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-412-2121
Mailing Address - Street 1:1300 S BRYAN RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-6626
Mailing Address - Country:US
Mailing Address - Phone:956-583-0004
Mailing Address - Fax:956-583-5790
Practice Address - Street 1:2302 S 77 SUNSHINESTRIP STE 101
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8371
Practice Address - Country:US
Practice Address - Phone:956-412-2121
Practice Address - Fax:956-412-2125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR30029261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX180651503Medicaid
TX180651502Medicaid
TX180651503Medicaid
TXFTX206Medicare PIN