1972760320 NPI number — LUMAR IMAGING INC.

Table of content: (NPI 1972760320)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972760320 NPI number — LUMAR IMAGING INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LUMAR IMAGING INC.
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:
Provider Other Organization Name Type Code:
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:
1972760320
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/21/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8968 KIRBY DR
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:
77054-2830
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-665-4823
Provider Business Mailing Address Fax Number:
713-665-6023

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8968 KIRBY DR
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:
77054-2830
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-665-4823
Provider Business Practice Location Address Fax Number:
713-665-6023
Provider Enumeration Date:
05/21/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FATHEREE
Authorized Official First Name:
JORRIE
Authorized Official Middle Name:
Authorized Official Title or Position:
BILLER
Authorized Official Telephone Number:
713-665-4823

Provider Taxonomy Codes

  • Taxonomy code: 2085B0100X , with the licence number:  E5682 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085N0700X , with the licence number: E5682 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085N0904X , with the licence number: E5682 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085P0229X , with the licence number: E5682 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: E5682 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2085R0203X , with the licence number: E5682 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0204X , with the licence number: E5682 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085U0001X , with the licence number: E5682 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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