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General NPI Number Information
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NPI Number | 1801833637
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Entity Type | Organization
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Legal Business Name | IMAGING CENTERS OF GREATER HOUSTON, LP
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6565 WEST LOOP S SUITE 100
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City | BELLAIRE
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State | TX
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Zip | 77401-3500
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Country | US
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Telephone | 713-668-5300
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Fax | 713-668-5304
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Provider Business Mailing Address
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Address Line | 6565 WEST LOOP S SUITE 100
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City | BELLAIRE
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State | TX
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Zip | 77401-3500
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Country | US
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Telephone | 713-668-5300
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Fax | 713-668-5304
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID J. MOELLER
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Credential | M.D.
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Telephone | 713-668-5300
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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 | R27763
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License Number State | TX
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