1013910991 NPI number — HOUSTON MEDICAL DIAGNOSTICS

Table of content: (NPI 1013910991)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013910991 NPI number — HOUSTON MEDICAL DIAGNOSTICS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOUSTON MEDICAL DIAGNOSTICS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MEDICAL CENTER IMAGING
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013910991
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7227 FANNIN ST
Provider Second Line Business Mailing Address:
STE 102
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77030-4848
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-797-6666
Provider Business Mailing Address Fax Number:
713-797-6677

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7227 FANNIN ST
Provider Second Line Business Practice Location Address:
STE 102
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77030-4848
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-797-6666
Provider Business Practice Location Address Fax Number:
713-797-6677
Provider Enumeration Date:
05/24/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BUTT
Authorized Official First Name:
MOIEN
Authorized Official Middle Name:
R
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
713-797-6666

Provider Taxonomy Codes

  • Taxonomy code: 2471C3401X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 2471M1202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)