Provider Demographics
NPI:1316404635
Name:ALLIANCE MRI PEARLAND LLC
Entity Type:Organization
Organization Name:ALLIANCE MRI PEARLAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:MATLACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-468-3842
Mailing Address - Street 1:140 CYPRESS STATION DR STE 130
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-1640
Mailing Address - Country:US
Mailing Address - Phone:713-955-5705
Mailing Address - Fax:281-580-1902
Practice Address - Street 1:1910 COUNTRY PLACE PKWY STE 154
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-2144
Practice Address - Country:US
Practice Address - Phone:713-468-3842
Practice Address - Fax:713-468-3845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-22
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)