MEDICARE: ADVANCED DIAGNOSTICS--OPEN MRI

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	261QM1200X	Magnetic Resonance Imaging (MRI) Clinic/Center

General Provider Information

NPI Number	:	1922001726
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED DIAGNOSTICS--OPEN MRI

Provider Business Mailing Address
First Line	:	1800 BERING DR
Second Line	:	SUITE 130
City	:	HOUSTON
State	:	TX
Zip	:	77057-3151
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 BERING DR
Second Line	:	STE 130
City	:	HOUSTON
State	:	TX
Zip	:	77057-3151
Country	:	US
Telephone Number	:	713-790-0467
Fax Number	:	713-797-5502

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DAVID BALAT
Credential	:
Telephone Number	:	281-335-8279

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	06/16/2008

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