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General NPI Number Information
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NPI Number | 1396912515
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Entity Type | Organization
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Legal Business Name | CARDIOTECH DIAGNOSTIC IMAGING
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Dates
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Enumeration Date | 05/15/2008
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Last Update Date | 05/15/2008
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Provider Practice Location Address
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Address Line | 12302 PLUMBROOK DR
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City | HOUSTON
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State | TX
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Zip | 77099-3008
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Country | US
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Telephone | 281-575-0093
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Fax |
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Provider Business Mailing Address
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Address Line | 12135 BISSONNET ST STE E
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City | HOUSTON
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State | TX
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Zip | 77099-1440
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Country | US
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Telephone | 281-495-0078
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Fax |
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Authorized Official
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Title or Position | OWNER-DIRECTOR
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Name | MRS. JOAN H DOUGLAS
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Credential |
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Telephone | 281-495-0078
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State | TX
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