Provider Demographics
NPI:1558366997
Name:CY-FAIR OPEN MRI
Entity Type:Organization
Organization Name:CY-FAIR OPEN MRI
Other - Org Name:FALLBROOK OPEN MRI
Other - Org Type:Doing Business As
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 8165
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:281-296-0093
Practice Address - Street 1:11770 FM 1960 WEST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065
Practice Address - Country:US
Practice Address - Phone:281-894-4000
Practice Address - Fax:281-894-6056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-14
Last Update Date:2009-01-07
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
TX4325571OtherCIGNA
TX1095655-01Medicaid
TX0004DCOtherBC BS
TX109565501Medicaid
TX353038100OtherUS DEPT OF LABOR
TX2024680OtherAETNA
TX109565501Medicaid
TX470001804Medicare ID - Type UnspecifiedMEDICARE RAILROAD