Healthcare Provider Details

I. General information

NPI: 1144263849
Provider Name (Legal Business Name): CHOPRA IMAGING CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 01/07/2021
Certification Date: 01/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 TWELVE OAKS DR
HOUSTON TX
77027-6812
US

IV. Provider business mailing address

1911 BAGBY ST
HOUSTON TX
77002-8594
US

V. Phone/Fax

Practice location:
  • Phone: 713-790-1666
  • Fax: 713-383-1302
Mailing address:
  • Phone: 713-383-7147
  • Fax: 713-383-1302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License NumberR25124
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License NumberL05566
License Number StateTX

VIII. Authorized Official

Name: LANISA GUIDRY
Title or Position: VP REVENUE CYCLE MANAGEMENT
Credential:
Phone: 713-795-1107