Provider Demographics
NPI:1467746495
Name:IRIS RADIOLOGY, LP
Entity Type:Organization
Organization Name:IRIS RADIOLOGY, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:FRITSCH
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:713-425-8108
Mailing Address - Street 1:1733 WOODSTEAD COURT
Mailing Address - Street 2:SUITE 206
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380
Mailing Address - Country:US
Mailing Address - Phone:713-425-8177
Mailing Address - Fax:713-425-8182
Practice Address - Street 1:1733 WOODSTEAD COURT
Practice Address - Street 2:SUITE 206
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380
Practice Address - Country:US
Practice Address - Phone:713-425-8177
Practice Address - Fax:713-425-8182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-07
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology