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General NPI Number Information
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NPI Number | 1013921006
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Entity Type | Organization
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Legal Business Name | LUMAR DIAGNOSTIC IMAGING, INC
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 8968 KIRBY DR
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City | HOUSTON
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State | TX
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Zip | 77054-2830
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Country | US
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Telephone | 713-665-4823
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Fax |
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Provider Business Mailing Address
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Address Line | 8968 KIRBY DR
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City | HOUSTON
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State | TX
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Zip | 77054-2830
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Country | US
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Telephone | 713-665-4823
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. JACKIE GREENWOOD
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Credential |
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Telephone | 713-665-4823
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number | R29053
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License Number State | TX
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