Provider Demographics
NPI:1841484607
Name:DIAGNOSTIC GROUP OF SOUTHEAST TEXAS LLC
Entity type:Organization
Organization Name:DIAGNOSTIC GROUP OF SOUTHEAST TEXAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:QAMAR
Authorized Official - Middle Name:U
Authorized Official - Last Name:ARFEEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-813-1677
Mailing Address - Street 1:3070 COLLEGE ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701-4691
Mailing Address - Country:US
Mailing Address - Phone:409-813-1677
Mailing Address - Fax:
Practice Address - Street 1:3070 COLLEGE ST
Practice Address - Street 2:SUITE 300
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4691
Practice Address - Country:US
Practice Address - Phone:409-813-1677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty