Healthcare Provider Details

I. General information

NPI: 1003679770
Provider Name (Legal Business Name): TEXAS OPEN MRI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 02/05/2024
Certification Date: 02/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 SOUTHWEST FWY STE 260
HOUSTON TX
77074-1520
US

IV. Provider business mailing address

9000 SOUTHWEST FWY STE 260
HOUSTON TX
77074-1520
US

V. Phone/Fax

Practice location:
  • Phone: 413-995-8818
  • Fax: 713-995-0505
Mailing address:
  • Phone: 713-820-2089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MUHAMMAD FAROOQ
Title or Position: DIRECTOR
Credential:
Phone: 713-820-2089