Provider Demographics
NPI:1629074786
Name:HOUSTON MEDICAL DIAGNOSTICS
Entity Type:Organization
Organization Name:HOUSTON MEDICAL DIAGNOSTICS
Other - Org Name:MEDICAL CENTER IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACCOUNTS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:MRB
Authorized Official - Phone:713-797-6666
Mailing Address - Street 1:7227 FANNIN ST
Mailing Address - Street 2:STE 102
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4848
Mailing Address - Country:US
Mailing Address - Phone:713-797-6666
Mailing Address - Fax:713-797-6677
Practice Address - Street 1:7227 FANNIN ST
Practice Address - Street 2:STE 102
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4848
Practice Address - Country:US
Practice Address - Phone:713-797-6666
Practice Address - Fax:713-797-6677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2471C3401X, 2471M1202X
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
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFTA095Medicare ID - Type UnspecifiedIDF