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General NPI Number Information
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NPI Number | 1538409347
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Entity Type | Organization
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Legal Business Name | MASTOLOGYUSA PLLC
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Dates
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Enumeration Date | 02/15/2013
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Last Update Date | 02/15/2013
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Provider Practice Location Address
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Address Line | 2424 W. HOLCOMBE BLVD SUITE 102
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City | HOUSTON
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State | TX
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Zip | 77030
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Country | US
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Telephone | 281-358-7758
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Fax | 281-358-7814
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Provider Business Mailing Address
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Address Line | 800 ROCKMEAD DR. SUITE 210
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City | KINGWOOD
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State | TX
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Zip | 77339
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MAHESH K SHETTY
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Credential | MD
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Telephone | 713-899-3797
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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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