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General NPI Number Information
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NPI Number | 1295846434
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Entity Type | Organization
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Legal Business Name | GOOD SHEPHERD IMAGING
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 02/27/2008
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Provider Practice Location Address
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Address Line | 10611 SAGEBRIAR DR
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City | HOUSTON
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State | TX
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Zip | 77089-3305
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Country | US
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Telephone | 281-481-9729
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Fax | 281-481-9729
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Provider Business Mailing Address
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Address Line | 10592A FUQUA ST # 243
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City | HOUSTON
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State | TX
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Zip | 77089-1402
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Country | US
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Telephone | 281-481-9729
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Fax | 281-481-9729
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MR. JEFF K. SHEPHERD
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Credential | R.T.
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Telephone | 281-481-9729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number | 11365
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License Number State | TX
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