Provider Demographics
NPI:1811309834
Name:YELLOW ROSE IMAGING
Entity type:Organization
Organization Name:YELLOW ROSE IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:AIJAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-235-5842
Mailing Address - Street 1:12323 ASHFORD HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-6177
Mailing Address - Country:US
Mailing Address - Phone:281-235-5842
Mailing Address - Fax:
Practice Address - Street 1:16753 DONWICK DR
Practice Address - Street 2:#A-6
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77385-3674
Practice Address - Country:US
Practice Address - Phone:713-542-2592
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-26
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QR0200X, 261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology