Provider Demographics
NPI:1922001726
Name:ADVANCED DIAGNOSTICS--OPEN MRI
Entity Type:Organization
Organization Name:ADVANCED DIAGNOSTICS--OPEN MRI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BALAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-335-8279
Mailing Address - Street 1:1800 BERING DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-3151
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1800 BERING DR
Practice Address - Street 2:STE 130
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-3151
Practice Address - Country:US
Practice Address - Phone:713-790-0467
Practice Address - Fax:713-797-5502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)