Provider Demographics
NPI:1013083625
Name:BAY COLONY MRI & DIAGNSOTIC CENTER, LP
Entity type:Organization
Organization Name:BAY COLONY MRI & DIAGNSOTIC CENTER, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-487-6736
Mailing Address - Street 1:3692 E SAM HOUSTON PKWY S
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-3137
Mailing Address - Country:US
Mailing Address - Phone:281-487-6736
Mailing Address - Fax:281-487-3187
Practice Address - Street 1:2401 FM 646 RD W
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-3249
Practice Address - Country:US
Practice Address - Phone:281-487-6736
Practice Address - Fax:281-487-3187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty