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General NPI Number Information
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NPI Number | 1558913236
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Entity Type | Organization
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Legal Business Name | SEGENVO LLC
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Dates
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Enumeration Date | 07/12/2019
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Last Update Date | 07/12/2019
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Provider Practice Location Address
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Address Line | 1420 STONEHOLLOW DR STE A
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City | KINGWOOD
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State | TX
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Zip | 77339-2494
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Country | US
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Telephone | 281-923-3788
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Fax |
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Provider Business Mailing Address
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Address Line | 1818 QUIET COUNTRY CT
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City | KINGWOOD
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State | TX
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Zip | 77345-1943
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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 | MANAGING PARTNER
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Name | KEN VOGEL
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Credential |
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Telephone | 281-923-3788
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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 |
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License Number State |
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