Provider Demographics
NPI:1811336159
Name:ALTUS BAYTOWN, LP
Entity type:Organization
Organization Name:ALTUS BAYTOWN, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR REGIONAL VP
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-981-5580
Mailing Address - Street 1:1404 W BAKER RD
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-2140
Mailing Address - Country:US
Mailing Address - Phone:409-981-5580
Mailing Address - Fax:409-981-5501
Practice Address - Street 1:1404 W BAKER RD
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-2140
Practice Address - Country:US
Practice Address - Phone:409-981-5580
Practice Address - Fax:409-981-5501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-20
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care