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General NPI Number Information
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NPI Number | 1265878219
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Entity Type | Organization
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Legal Business Name | GREEN IMAGING, PLLC
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Dates
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Enumeration Date | 05/17/2013
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 2020 ALBANS RD
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City | HOUSTON
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State | TX
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Zip | 77005-1643
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Country | US
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Telephone | 713-775-7252
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Fax |
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Provider Business Mailing Address
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Address Line | 2020 ALBANS RD
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City | HOUSTON
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State | TX
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Zip | 77005-1643
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Country | US
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Telephone | 713-775-7252
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CRISTIN A DICKERSON
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Credential | MD
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Telephone | 713-775-7252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | L8605
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License Number State | TX
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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 | L8605
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | H7998
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License Number State | TX
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