Diagnostic Group Imaging PLLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

DIAGNOSTIC GROUP IMAGING PLLC

Practice address

3480 College St
Suite 200
Beaumont, TX 77701

Phone

(409) 813-1677

Fax

(409) 813-1699

NPI assigned

Jun 6, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Brad Thibodaux

Title

Chief Data Officer

Phone

(409) 730-2022

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532908800000",
    "number": "1477933299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3406 COLLEGE ST",
            "address_2": "SUITE 200",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014612",
            "telephone_number": "409-813-1677",
            "fax_number": "409-813-1699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3480 COLLEGE ST",
            "address_2": "SUITE 200",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "77701",
            "telephone_number": "409-813-1677",
            "fax_number": "409-813-1699"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3282 College St",
            "address_purpose": "LOCATION",
            "city": "Beaumont",
            "state": "TX",
            "postal_code": "777014610",
            "country_code": "US",
            "telephone_number": "409-813-1677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DIAGNOSTIC GROUP IMAGING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-06",
        "last_updated": "2018-07-30",
        "status": "A",
        "authorized_official_last_name": "THIBODAUX",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "CHIEF DATA OFFICER",
        "authorized_official_telephone_number": "409-730-2022"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sunita Devi, M.D.
• Tara Boudoin Deville, NP
• Cassandra Covington Dewall, M.ED, LPC
• Gurpartap Dhillon, OD
• Diagnostic & Internal Medicine Clinic PA
• Diagnostic Group Integrated Healthcare System PLLC
• Diagnostic Group of Southeast Texas LLC
• Diagnostic Health Centers of Texas, Limited Partnership
• Diagnostic Pathology Associates, LLP
• Diagnostic Pathology Associates, LLP

• All providers in Beaumont, TX
• Radiology Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.