MEDICARE: SPENCER RADIOLOGY NO 3 LLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician

General Provider Information

NPI Number	:	1134232549
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPENCER RADIOLOGY NO 3 LLP

Provider Business Mailing Address
First Line	:	3000 RICHMOND AVE
Second Line	:	#300
City	:	HOUSTON
State	:	TX
Zip	:	77098-3102
Country	:	US
Telephone Number	:	713-512-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	3000 RICHMOND AVE
Second Line	:	#300
City	:	HOUSTON
State	:	TX
Zip	:	77098-3102
Country	:	US
Telephone Number	:	713-512-6000
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. STUART AKESON
Credential	:
Telephone Number	:	281-358-7758

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	10/04/2007

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