Provider Demographics
NPI:1366447708
Name:WOODSTEAD MRI, INC.
Entity Type:Organization
Organization Name:WOODSTEAD MRI, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:OHILDA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:STERLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-681-8040
Mailing Address - Street 1:PO BOX 7865
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77387
Mailing Address - Country:US
Mailing Address - Phone:281-681-8040
Mailing Address - Fax:291-296-0093
Practice Address - Street 1:1733 WOODSTEAD CT.
Practice Address - Street 2:STE #100
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380
Practice Address - Country:US
Practice Address - Phone:281-364-8840
Practice Address - Fax:281-298-7309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-14
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QR0200X
TX293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX377368700OtherUS DEPT OF LABOR
TX0806002-02Medicaid
TX0043BROtherBC BS
TX080600202Medicaid
TX1015356OtherAETNA
TX3087436OtherCIGNA
TX1015356OtherAETNA
TX0043BROtherBC BS