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NPI Code Detail

MEDICARE: IMAGE AMERICA DIAGNOSTIC IMAGING CENTER, LTD

MEDICARE: IMAGE AMERICA DIAGNOSTIC IMAGING CENTER, LTD
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
12085R0202XDiagnostic Radiology Physician

General Provider Information

NPI Number : 1770695819
Entity Type Code : Organization
Provider Name (Legal Business Name) : IMAGE AMERICA DIAGNOSTIC IMAGING CENTER, LTD
Provider Business Mailing Address
First Line : 3391 WESTPARK DR
Second Line :
City : HOUSTON
State : TX
Zip : 77005-4262
Country : US
Telephone Number : 713-660-8383
Fax Number : 713-663-6262
Provider Business Practice Location Address
First Line : 3391 WESTPARK DR
Second Line :
City : HOUSTON
State : TX
Zip : 77005-4262
Country : US
Telephone Number : 713-660-8383
Fax Number : 713-663-6262
Authorized Official
Title or Position : PRESIDENT
Name : MR. BRIAN DAVID MOBLEY
Credential :
Telephone Number : 713-660-8383
Provider Enumeration Date : 08/31/2006
Last Update Date : 08/22/2020

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Directions to “IMAGE AMERICA DIAGNOSTIC IMAGING CENTER, LTD ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.