Provider Demographics
NPI:1134324072
Name:IMAGING WILLOWBROOK, LLC
Entity Type:Organization
Organization Name:IMAGING WILLOWBROOK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:CESTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-785-7828
Mailing Address - Street 1:10370 RICHMOND AVE
Mailing Address - Street 2:SUITE 1125
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-4141
Mailing Address - Country:US
Mailing Address - Phone:713-785-7828
Mailing Address - Fax:713-785-7858
Practice Address - Street 1:22475 TOMBALL PKWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-1530
Practice Address - Country:US
Practice Address - Phone:713-785-7828
Practice Address - Fax:713-785-7858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Not Answered261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology