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General NPI Number Information
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NPI Number | 1245396969
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Entity Type | Organization
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Legal Business Name | LAKESIDE MRI & DIAGNOSTIC CENTER
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 11/17/2022
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Provider Practice Location Address
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Address Line | 17360 HIGHWAY 3
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City | WEBSTER
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State | TX
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Zip | 77598-4133
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Country | US
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Telephone | 281-338-5575
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Fax | 281-554-8407
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Provider Business Mailing Address
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Address Line | PO BOX 890313
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City | HOUSTON
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State | TX
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Zip | 77289-0313
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Country | US
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Telephone | 281-338-5575
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Fax | 281-554-8407
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Authorized Official
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Title or Position | PRESIDENT
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Name | SAMEER ABDULHUSSEIN
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Credential |
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Telephone | 833-633-7331
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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