Provider Demographics
NPI:1508208018
Name:WILLOWBROOK IMAGING LLC
Entity Type:Organization
Organization Name:WILLOWBROOK IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MBR
Authorized Official - Prefix:
Authorized Official - First Name:RANJIT
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-831-3600
Mailing Address - Street 1:13652 BRETON RIDGE ST STE B
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-6088
Mailing Address - Country:US
Mailing Address - Phone:832-831-3600
Mailing Address - Fax:888-628-3870
Practice Address - Street 1:13652 BRETON RIDGE ST STE B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-6088
Practice Address - Country:US
Practice Address - Phone:832-831-3600
Practice Address - Fax:888-628-3870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-25
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology