Provider Demographics
NPI:1871662189
Name:UNIVERSAL MRI AND DIAGNOSTICS INC
Entity Type:Organization
Organization Name:UNIVERSAL MRI AND DIAGNOSTICS INC
Other - Org Name:UNIVERSAL BAYTOWN MRI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:E
Authorized Official - Last Name:DEL VALLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-422-9900
Mailing Address - Street 1:PO BOX 1647
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77522-1647
Mailing Address - Country:US
Mailing Address - Phone:281-422-9900
Mailing Address - Fax:281-422-9910
Practice Address - Street 1:4310A GARTH RD
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3114
Practice Address - Country:US
Practice Address - Phone:281-422-9900
Practice Address - Fax:281-422-9910
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSAL MRI AND DIAGNOSTICS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-08
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX265501Medicare PIN