MEDICARE: GALLERIA MRI & DIAGNOSTIC, LLC

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	174400000X	Specialist

General Provider Information

NPI Number	:	1194059022
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GALLERIA MRI & DIAGNOSTIC, LLC

Provider Business Mailing Address
First Line	:	3391 WESTPARK DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005-4262
Country	:	US
Telephone Number	:	832-882-6742
Fax Number	:

Provider Business Practice Location Address
First Line	:	3391 WESTPARK DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005-4262
Country	:	US
Telephone Number	:	832-882-6742
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RAHUL DHAWAN
Credential	:
Telephone Number	:	832-882-6742

Provider Enumeration Date	:	09/24/2009
Last Update Date	:	08/23/2021

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