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General NPI Number Information
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NPI Number | 1326589888
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Entity Type | Organization
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Legal Business Name | INFINITY DIAGNOSTICS CENTER LLC
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Dates
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Enumeration Date | 03/17/2017
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Last Update Date | 03/17/2017
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Provider Practice Location Address
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Address Line | 3310 EDLOE ST
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City | HOUSTON
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State | TX
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Zip | 77027-6502
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Country | US
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Telephone | 713-369-7066
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Fax | 713-369-7067
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Provider Business Mailing Address
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Address Line | 3310 EDLOE ST
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City | HOUSTON
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State | TX
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Zip | 77027-6502
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Country | US
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Telephone | 713-369-7066
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Fax | 713-369-7067
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Authorized Official
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Title or Position | CEO
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Name | JESSICA DAWN HATCH
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Credential |
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Telephone | 832-656-3460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State | TX
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