=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861435786
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CENTER FOR CARDIVASCULAR ,CT ANGIOGRAPHY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/14/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1429 HIGHWAY 6
-----------------------------------------------------
City | SUGARLAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77478
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-371-5725
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1429 HIGHWAY 6
-----------------------------------------------------
City | SUGARLAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77478
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-371-5725
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PARTNER
-----------------------------------------------------
Name | DR. GHASSAN J AL-ZAGHRINI
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 713-917-5723
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QR0208X
-----------------------------------------------------
Taxonomy Name | Mobile Radiology Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------