=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093954547
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NORTH HOUSTON IMAGING CENTER,LTD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/06/2009
-----------------------------------------------------
Last Update Date | 02/06/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 237 NORTH LOOP W
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77008-2245
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-861-8188
-----------------------------------------------------
Fax | 713-862-1733
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 237 NORTH LOOP W
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77008-2245
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-861-8188
-----------------------------------------------------
Fax | 713-862-1733
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | RADIOLOGIST
-----------------------------------------------------
Name | DR. JONN S. LEE
-----------------------------------------------------
Credential | M.D.,D.A.B.R.
-----------------------------------------------------
Telephone | 713-861-8188
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM1200X
-----------------------------------------------------
Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
-----------------------------------------------------
License Number | MDG1072
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QM1200X
-----------------------------------------------------
Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
-----------------------------------------------------
License Number | MDE9766
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------