Provider Demographics
NPI:1467608596
Name:BLOC MEDI CORP
Entity Type:Organization
Organization Name:BLOC MEDI CORP
Other - Org Name:BREAST IMAGING CENTERS OF TEXAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:D
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:713-666-4224
Mailing Address - Street 1:5555 WEST LOOP S
Mailing Address - Street 2:STE 350
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2100
Mailing Address - Country:US
Mailing Address - Phone:713-715-4800
Mailing Address - Fax:713-715-4840
Practice Address - Street 1:5555 WEST LOOP S
Practice Address - Street 2:STE 350
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2100
Practice Address - Country:US
Practice Address - Phone:713-715-4800
Practice Address - Fax:713-715-4840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-08
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX801013885261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service