Provider Demographics
NPI:1073975777
Name:ALLIANCE MOBILE IMAGING
Entity Type:Organization
Organization Name:ALLIANCE MOBILE IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ETHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-773-2018
Mailing Address - Street 1:9811 KATY FWY
Mailing Address - Street 2:SUITE 1075
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1273
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9811 KATY FWY
Practice Address - Street 2:SUITE 1075
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1273
Practice Address - Country:US
Practice Address - Phone:713-468-3842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile