Provider Demographics
NPI:1952349961
Name:FOUNDATION IMAGING AFFILIATES OF SW HOUSTON, LLP
Entity Type:Organization
Organization Name:FOUNDATION IMAGING AFFILIATES OF SW HOUSTON, LLP
Other - Org Name:DOCTORS' IMAGING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-541-6111
Mailing Address - Street 1:8111 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1705
Mailing Address - Country:US
Mailing Address - Phone:713-541-6111
Mailing Address - Fax:713-541-0111
Practice Address - Street 1:8111 SOUTHWEST FWY
Practice Address - Street 2:SUITE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1705
Practice Address - Country:US
Practice Address - Phone:713-541-6111
Practice Address - Fax:713-541-0111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR27436261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFTX128Medicare ID - Type Unspecified