Healthcare Provider Details

I. General information

NPI: 1225407687
Provider Name (Legal Business Name): SUGAR LAND IMAGING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

2655 CORDES DR SUITE 130
SUGAR LAND TX
77479-1460
US

IV. Provider business mailing address

2655 CORDES DR SUITE 130
SUGAR LAND TX
77479-1460
US

V. Phone/Fax

Practice location:
  • Phone: 832-667-8132
  • Fax: 281-664-5899
Mailing address:
  • Phone: 832-667-8132
  • Fax: 281-664-5899

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. RAHUL DHAWAN
Title or Position: CEO
Credential:
Phone: 832-667-8132