Healthcare Provider Details
I. General information
NPI: 1558350330
Provider Name (Legal Business Name): HUMBLE RADIOLOGY ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/14/2005
Last Update Date: 03/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
110 SHULT DR
COLUMBUS TX
78934-3016
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:
CREED
ABELL
IV
Title or Position: PRESIDENT
Credential: M.D.
Phone: 281-359-7788