Provider Demographics
NPI:1689862062
Name:SPENCER RADIOLOGY NO 3 LLP
Entity Type:Organization
Organization Name:SPENCER RADIOLOGY NO 3 LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:
Authorized Official - Last Name:AKESON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-358-7758
Mailing Address - Street 1:3000 RICHMOND AVE
Mailing Address - Street 2:#300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-3102
Mailing Address - Country:US
Mailing Address - Phone:713-852-6682
Mailing Address - Fax:
Practice Address - Street 1:3000 RICHMOND AVE
Practice Address - Street 2:#300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-3102
Practice Address - Country:US
Practice Address - Phone:713-852-6682
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-10
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00340UMedicare PIN