Provider Demographics
NPI:1851334114
Name:HOUSTON PROGRESSIVE RADIOLOGY ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:HOUSTON PROGRESSIVE RADIOLOGY ASSOCIATES, PLLC
Other - Org Name:RADIOLOGY WEST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:M
Authorized Official - Last Name:HARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-218-9368
Mailing Address - Street 1:7600 W TIDWELL RD STE 103
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-5719
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5301 HOLLISTER ST
Practice Address - Street 2:STE 350
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77040-6100
Practice Address - Country:US
Practice Address - Phone:713-461-3573
Practice Address - Fax:713-468-1247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX112877904Medicaid
TX112877904Medicaid