Provider Demographics
NPI:1578565396
Name:MASTER IMAGING, LLC
Entity Type:Organization
Organization Name:MASTER IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:RT(R)(CT)(MR)
Authorized Official - Phone:281-412-5840
Mailing Address - Street 1:3231 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-4501
Mailing Address - Country:US
Mailing Address - Phone:281-412-5840
Mailing Address - Fax:281-412-5818
Practice Address - Street 1:3231 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-4501
Practice Address - Country:US
Practice Address - Phone:281-412-5840
Practice Address - Fax:281-412-5818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2471C3401XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistComputed TomographyGroup - Multi-Specialty
Not Answered2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance ImagingGroup - Multi-Specialty
Not Answered2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0412DCOtherBLUE CROSS BLUE SHIELD
TX0412DCOtherBLUE CROSS BLUE SHIELD