Provider Demographics
NPI:1003814286
Name:WOODLAKE IMAGING
Entity Type:Organization
Organization Name:WOODLAKE IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-242-6200
Mailing Address - Street 1:9600 WESTHEIMER RD
Mailing Address - Street 2:SUITE 12A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-3205
Mailing Address - Country:US
Mailing Address - Phone:832-242-6200
Mailing Address - Fax:832-242-6201
Practice Address - Street 1:9600 WESTHEIMER RD
Practice Address - Street 2:SUITE 12A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-3205
Practice Address - Country:US
Practice Address - Phone:832-242-6200
Practice Address - Fax:832-242-6201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00181VMedicare ID - Type Unspecified