Healthcare Provider Details
I. General information
NPI: 1518995554
Provider Name (Legal Business Name): RADMEDX PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/29/2006
Last Update Date: 10/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3201 HWY 71 EAST
BASTROP TX
78602
US
IV. Provider business mailing address
800 ROCKMEAD DR STE 210
KINGWOOD TX
77339
US
V. Phone/Fax
- Phone: 281-359-7788
- Fax: 281-359-7888
- Phone: 281-359-7788
- Fax: 281-359-7888
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GREGORY
BELL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 281-359-7788