TELEVYDE LLC NPI 1871507657

NPI Information

NPI: 1871507657
Provider Name: TELEVYDE, LLC
Classification: Clinic/Center - 261QM1200X
Specialization: Magnetic Resonance Imaging (MRI)
Entity Type: Organization
Address: 3201 UNIVERSITY DR E STE 325
BRYAN, TX
ZIP 77802
Phone: (979) 774-4563

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NPI Details

TELEVYDE, LLC is a magnetic resonance imaging (mri) clinic center in Bryan, TX. TELEVYDE, LLC NPI is 1871507657. The provider is registered as an organization entity type.

The provider's business location address is:

3201 UNIVERSITY DR E STE 325
BRYAN, TX
ZIP 77802-478
Phone: (979) 774-4563
Fax: (979) 774-4546

The provider's authorized official is Jackie Greenwood .
The authorized official title is Ceo and has the following contact phone number (979) 774-4563.

The enumeration date for this NPI number is 7/28/2006 and was last updated on 4/13/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0200X	Clinic/Center	Radiology			No
2	261QM1200X	Clinic/Center	Magnetic Resonance Imaging (MRI)	R29053	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00453T	MEDICARE PIN	TEXAS
2	161716901	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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