Organization Active NPI

Professional Imaging, PLLC

  • Geriatric Medicine (Family Medicine) Physician
  • Humble, TX
National Provider Identifier
1902835895
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
PROFESSIONAL IMAGING, PLLC
Practice address
1717 Rotary Dr
Humble, TX 77338-5235
Phone
(866) 676-6277
Fax
(281) 272-6281
NPI assigned
Jul 2, 2006
Last updated
Feb 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Authorized official

Name
Mr. Ben Louis Baumer
Title
Account Manager
Phone
(281) 272-6277

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X Primary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X

Addresses

Primary practice location

1717 Rotary Dr
Humble, TX 77338-5235

Mailing address

6078 Bridgeview Dr
Ventura, CA 93003-1126
Phone (805) 293-1573

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041230000377 TX Part B Supplier - Clinic/Group Practice 7012975527 Receives reassigned benefits from 29 practitioners
O20230223002350 IL Part B Supplier - Clinic/Group Practice 7012975527 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL; Lisle, IL

National Provider Directory

National Provider Directory

Locations (25 of 88)

3718 Jefferson Ave
Texarkana, AR 71854
Phone (224) 337-1000

800 Coyote Trl
#3P
Alice, TX 78332
Phone (361) 666-3800

150 Blue Heron Pkwy
Baytown, TX 77521
Phone (281) 724-5442

1020 S 23rd St
Beaumont, TX 77707
Phone (409) 842-9700

3840 Pointe Pkwy
Beaumont, TX 77706
Phone (409) 892-6811

2401 Development Blvd
#2X
Bellmead, TX 76705
Phone (254) 296-8976

1103 Mary Jane St
Belton, TX 76513
Phone (254) 939-9327

401 E Blue Bell Rd
#6A
Brenham, TX 77833
Phone (979) 836-6611

440 Ruben Torres SR Blvd
Brownsville, TX 78520
Phone (956) 546-7378

2104 N Karnes Ave
#3M
Cameron, TX 76520
Phone (254) 697-4985

2202 N Travis Ave
#3N
Cameron, TX 76520
Phone (254) 697-6564

1661 S Buffalo St
Canton, TX 75103
Phone (903) 567-4135

8449 FM 471 S
#5D
Castroville, TX 78009
Phone (830) 931-2243

2507 S Loop 336 W
Conroe, TX 77304
Phone (410) 207-6953

7700 Mesquite Pass
Converse, TX 78109
Phone (210) 650-0551

810 Industrial Ave
#3R
Copperas Cove, TX 76522
Phone (254) 547-9552

1101 S Alameda St
Corpus Christi, TX 78404
Phone (361) 882-2711

6226 Saratoga Blvd
Corpus Christi, TX 78414
Phone (361) 986-1600

3301 W Park Row Blvd
Corsicana, TX 75110
Phone (903) 872-2455

13600 Birdcall Ln
#4E
Cypress, TX 77429
Phone (281) 447-7771

601 E Reunion St
#5V
Fairfield, TX 75840
Phone (903) 389-4121

624 N Converse St
#5Q
Flatonia, TX 78941
Phone (361) 865-3571

200 Veterans Dr
Floresville, TX 78114
Phone (830) 216-9456

300 S Highway 36 Byp N
#3B
Gatesville, TX 76528
Phone (254) 865-7575

1400 N Main St
#5P
Giddings, TX 78942
Phone (979) 542-1755

Practitioners & affiliated clinicians

Practitioners 51

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675641600000",
    "number": "1902835895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6078 BRIDGEVIEW DR",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031126",
            "telephone_number": "805-293-1573",
            "fax_number": "805-275-1842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 ROTARY DR",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773385235",
            "telephone_number": "866-676-6277",
            "fax_number": "281-272-6281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL IMAGING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A",
        "authorized_official_last_name": "BAUMER",
        "authorized_official_first_name": "BEN",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "ACCOUNT MANAGER",
        "authorized_official_telephone_number": "281-272-6277",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humble, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.