Provider Demographics
NPI:1770728826
Name:HOUSTON DIAGNOSTIC CATH LAB LP
Entity type:Organization
Organization Name:HOUSTON DIAGNOSTIC CATH LAB LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDRANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-580-0402
Mailing Address - Street 1:6655 TRAVIS ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1312
Mailing Address - Country:US
Mailing Address - Phone:713-580-0401
Mailing Address - Fax:713-580-0411
Practice Address - Street 1:16651 SOUTHWEST FWY
Practice Address - Street 2:SUITE 250
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2345
Practice Address - Country:US
Practice Address - Phone:713-580-0401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty