Provider Demographics
NPI:1700209723
Name:ALLIANCE RADIOLOGY, PLLC
Entity Type:Organization
Organization Name:ALLIANCE RADIOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-816-9714
Mailing Address - Street 1:1701 HERMANN DR
Mailing Address - Street 2:UNIT 2602
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-7452
Mailing Address - Country:US
Mailing Address - Phone:713-816-9714
Mailing Address - Fax:713-528-5186
Practice Address - Street 1:1701 HERMANN DR
Practice Address - Street 2:UNIT 2602
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-7452
Practice Address - Country:US
Practice Address - Phone:713-816-9714
Practice Address - Fax:713-528-5186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-27
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG74312085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty