Provider Demographics
NPI:1598896516
Name:UNICARE MRI & DIAGNOSTIC CENTER LLC
Entity Type:Organization
Organization Name:UNICARE MRI & DIAGNOSTIC CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:RASSOLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-691-6700
Mailing Address - Street 1:7007 NORTH FREEWAY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77076-1348
Mailing Address - Country:US
Mailing Address - Phone:713-691-6700
Mailing Address - Fax:
Practice Address - Street 1:7007 NORTH FWY
Practice Address - Street 2:SUITE 110
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77076
Practice Address - Country:US
Practice Address - Phone:713-691-6700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDG2834OtherMEDICARE RAILROAD
TX187000801Medicaid
TX187000801Medicaid