1184174757 NPI number — AFFORDABLE MRI & DIAGNOSTIC IMAGING

Table of content: (NPI 1184174757)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184174757 NPI number — AFFORDABLE MRI & DIAGNOSTIC IMAGING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AFFORDABLE MRI & DIAGNOSTIC IMAGING
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:
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Provider Other Last Name:
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NPI Number Information

NPI Number:
1184174757
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/07/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2020 ALBANS RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77005-1643
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-831-8662
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14555 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77035-6560
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-831-8662
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/07/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SWOPE
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
713-542-9968

Provider Taxonomy Codes

  • Taxonomy code: 261QM1200X , with the licence number:  2085R0202X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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