Healthcare Provider Details

I. General information

NPI: 1326526583
Provider Name (Legal Business Name): MEDICAL IMAGING PARTNERS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2018
Last Update Date: 06/29/2021
Certification Date: 06/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5037 B FM 2920 RD
SPRING TX
77388
US

IV. Provider business mailing address

5037 B FM 2920 RD
SPRING TX
77388
US

V. Phone/Fax

Practice location:
  • Phone: 281-402-3134
  • Fax: 281-453-2203
Mailing address:
  • Phone: 281-453-7916
  • Fax: 281-453-2203

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 Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: ARIN TIJERINA
Title or Position: DIRECTOR OF CREDENTIALING
Credential:
Phone: 361-549-0415