Provider Demographics
NPI:1114374931
Name:PINK DOOR IMAGING CENTER LLC
Entity Type:Organization
Organization Name:PINK DOOR IMAGING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHESH
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHETTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-899-3797
Mailing Address - Street 1:2424 W HOLCOMBE BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1933
Mailing Address - Country:US
Mailing Address - Phone:832-804-8119
Mailing Address - Fax:832-804-8120
Practice Address - Street 1:2424 W HOLCOMBE BLVD STE 102
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1933
Practice Address - Country:US
Practice Address - Phone:832-804-8119
Practice Address - Fax:832-804-8120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-22
Last Update Date:2016-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography