Provider Demographics
NPI:1952933012
Name:TEXAS IMAGING CENTER LLC
Entity type:Organization
Organization Name:TEXAS IMAGING CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTATOR
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:R
Authorized Official - Last Name:LARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-855-3080
Mailing Address - Street 1:17516 US HIGHWAY 59 STE 100
Mailing Address - Street 2:
Mailing Address - City:NEW CANEY
Mailing Address - State:TX
Mailing Address - Zip Code:77357-8718
Mailing Address - Country:US
Mailing Address - Phone:832-855-3080
Mailing Address - Fax:
Practice Address - Street 1:17516 US HIGHWAY 59 STE 100
Practice Address - Street 2:
Practice Address - City:NEW CANEY
Practice Address - State:TX
Practice Address - Zip Code:77357-8718
Practice Address - Country:US
Practice Address - Phone:832-855-3080
Practice Address - Fax:281-689-9011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-06
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology