Healthcare Provider Details

I. General information

NPI: 1952349961
Provider Name (Legal Business Name): FOUNDATION IMAGING AFFILIATES OF SW HOUSTON, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8111 SOUTHWEST FWY SUITE 100
HOUSTON TX
77074-1705
US

IV. Provider business mailing address

8111 SOUTHWEST FWY SUITE 100
HOUSTON TX
77074-1705
US

V. Phone/Fax

Practice location:
  • Phone: 713-541-6111
  • Fax: 713-541-0111
Mailing address:
  • Phone: 713-541-6111
  • Fax: 713-541-0111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License NumberR27436
License Number StateTX

VIII. Authorized Official

Name: MS. EILEEN SALAZAR
Title or Position: MANAGER
Credential:
Phone: 713-541-6111