Provider Demographics
NPI:1932152436
Name:E PLUS PET IMAGING XXI LP
Entity Type:Organization
Organization Name:E PLUS PET IMAGING XXI LP
Other - Org Name:PET IMAGING OF WILLOWBROOK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO OF GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:RHYMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-467-7415
Mailing Address - Street 1:13300 HARGRAVE RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4373
Mailing Address - Country:US
Mailing Address - Phone:832-327-3900
Mailing Address - Fax:832-327-3902
Practice Address - Street 1:13300 HARGRAVE RD
Practice Address - Street 2:SUITE 130
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4373
Practice Address - Country:US
Practice Address - Phone:832-327-3900
Practice Address - Fax:832-327-3902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0493DCOtherBLUE CROSS/BLUE SHIELD
TX0493DCOtherBLUE CROSS/BLUE SHIELD