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General NPI Number Information
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NPI Number | 1487104246
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Entity Type | Organization
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Legal Business Name | UPRIGHT MRI OF CLEARLAKE
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Dates
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Enumeration Date | 10/05/2016
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Last Update Date | 10/05/2016
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Provider Practice Location Address
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Address Line | 1202 NASA PKWY
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City | HOUSTON
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State | TX
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Zip | 77058-3304
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Country | US
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Telephone | 281-335-0505
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Fax | 281-335-2020
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Provider Business Mailing Address
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Address Line | 3502 SPID DR
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City | CORPUS CHRISTI
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State | TX
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Zip | 78415-2909
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Country | US
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Telephone | 361-854-4400
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Fax | 361-854-4420
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Authorized Official
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Title or Position | COO
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Name | MRS. VERONICA JOHNSON
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Credential |
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Telephone | 361-854-4400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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