MEMORIAL MRI AND DIAGNOSTIC LLC NPI 1912989120

NPI Information

NPI: 1912989120
Provider Name: MEMORIAL MRI AND DIAGNOSTIC LLC
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

CLIA Number: 45D2037923

Address:
1346 CAMPBELL RD
HOUSTON, TX
ZIP 77055
Phone: (713) 461-3399
Get Directions

MEMORIAL MRI AND DIAGNOSTIC LLC is a diagnostic radiology radiology in Houston, TX. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. MEMORIAL MRI AND DIAGNOSTIC LLC NPI is 1912989120. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1346 CAMPBELL RD
HOUSTON, TX
ZIP 77055-404
Phone: (713) 461-3399
Fax: (713) 463-5996

The provider's authorized official is Kim Tran .
The authorized official title is Vice President and has the following contact phone number (713) 461-3399.

The CLIA number assigned to this NPI record is 45D2037923 - other - clinic group practice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/15/2005 and was last updated on 12/31/2019.

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	2085B0100X	Radiology	Body Imaging	R26701	TEXAS	No
2	2085N0904X	Radiology	Nuclear Radiology	R26701	TEXAS	No
3	2085R0202X	Radiology	Diagnostic Radiology	R26701	TEXAS	Yes
4	2085R0203X	Radiology	Therapeutic Radiology	R26701	TEXAS	No
5	2085R0204X	Radiology	Vascular & Interventional Radiology	R26701	TEXAS	No
6	2085U0001X	Radiology	Diagnostic Ultrasound	R26701	TEXAS	No

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	153985002	MEDICAID	TEXAS
2	1539850-01	MEDICAID	TEXAS
3	0203DC	OTHER	TEXAS	BLUE CROSS PROVIDER#

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: 4/28/2024

NPI Synchronization or Removal

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