Healthcare Provider Details

I. General information

NPI: 1497124903
Provider Name (Legal Business Name): HSRC DIAGNOSTIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2015
Last Update Date: 09/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26218 INTERSTATE 45 N SUITE B
SPRING TX
77386-1024
US

IV. Provider business mailing address

26218 INTERSTATE 45 N SUITE B
SPRING TX
77386-1024
US

V. Phone/Fax

Practice location:
  • Phone: 832-667-8132
  • Fax:
Mailing address:
  • Phone: 832-667-8132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. PHIL SANCHEZ
Title or Position: CEO
Credential:
Phone: 832-922-9440