Provider Demographics
NPI:1851860472
Name:TEXAS URGENT CARE & IMAGING CENTER
Entity Type:Organization
Organization Name:TEXAS URGENT CARE & IMAGING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:G
Authorized Official - Last Name:BERDAYES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:281-728-4166
Mailing Address - Street 1:451 KINGWOOD MEDICAL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-6408
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17516 US HIGHWAY 59S
Practice Address - Street 2:
Practice Address - City:NEW CANEY
Practice Address - State:TX
Practice Address - Zip Code:77357
Practice Address - Country:US
Practice Address - Phone:281-728-4166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-14
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
9946061OtherAETNA