Provider Demographics
NPI:1265689939
Name:BRAZORIA COUNTY IMAGING CENTER
Entity Type:Organization
Organization Name:BRAZORIA COUNTY IMAGING CENTER
Other - Org Name:ANGLETON OPEN MRI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:SEARLS
Authorized Official - Last Name:NEIDERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-792-6736
Mailing Address - Street 1:700 N. FRONT STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:ANGLETON
Mailing Address - State:TX
Mailing Address - Zip Code:77515-4431
Mailing Address - Country:US
Mailing Address - Phone:806-792-6736
Mailing Address - Fax:806-792-6743
Practice Address - Street 1:700 N. FRONT STREET
Practice Address - Street 2:SUITE B
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515
Practice Address - Country:US
Practice Address - Phone:806-792-6736
Practice Address - Fax:806-792-6743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-25
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)