Provider Demographics
NPI:1093811960
Name:WILLOWBROOK MRI
Entity Type:Organization
Organization Name:WILLOWBROOK MRI
Other - Org Name:CY-FAIR BONE AND JOINT
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MYNATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-955-7577
Mailing Address - Street 1:PO BOX 4396
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4396
Mailing Address - Country:US
Mailing Address - Phone:281-955-7577
Mailing Address - Fax:281-955-5875
Practice Address - Street 1:13300 HARGRAVE RD
Practice Address - Street 2:SUITE 110
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4373
Practice Address - Country:US
Practice Address - Phone:281-955-7577
Practice Address - Fax:281-955-5875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)