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General NPI Number Information
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NPI Number | 1912989120
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Entity Type | Organization
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Legal Business Name | MEMORIAL MRI AND DIAGNOSTIC LLC
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Dates
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Enumeration Date | 11/15/2005
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 1346 CAMPBELL RD
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City | HOUSTON
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State | TX
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Zip | 77055-6404
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Country | US
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Telephone | 713-461-3399
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Fax | 713-463-5996
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Provider Business Mailing Address
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Address Line | PO BOX 55159
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City | HOUSTON
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State | TX
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Zip | 77255-5159
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Country | US
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Telephone | 713-461-3399
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Fax | 713-461-1969
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | FRED HUANG
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Credential |
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Telephone | 713-461-3399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number | R26701
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number | R26701
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2085R0203X
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Taxonomy Name | Therapeutic Radiology Physician
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License Number | R26701
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | R26701
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | R26701
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | R26701
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License Number State | TX
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