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General NPI Number Information
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NPI Number | 1053679449
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Entity Type | Organization
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Legal Business Name | FIRST CHOICE IMAGING
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Dates
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Enumeration Date | 04/24/2012
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Last Update Date | 04/24/2012
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Provider Practice Location Address
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Address Line | 8831 LONG POINT RD 104
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City | HOUSTON
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State | TX
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Zip | 77055-3022
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Country | US
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Telephone | 713-894-1809
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Fax | 713-588-1809
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Provider Business Mailing Address
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Address Line | 8831 LONG POINT RD 104
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City | HOUSTON
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State | TX
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Zip | 77055-3022
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Country | US
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Telephone | 713-894-1809
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Fax | 713-588-1809
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Authorized Official
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Title or Position | OWNER
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Name | KIM MANSIK
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Credential | RCS,RVS
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Telephone | 713-894-1809
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471V0105X
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Taxonomy Name | Vascular Sonography Radiologic Technologist
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License Number | 00074629
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License Number State | TX
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