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General NPI Number Information
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NPI Number | 1972639219
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Entity Type | Organization
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Legal Business Name | ADVANCED OPEN MRI
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9802 FM 1960 BYPASS RD W #110
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City | HUMBLE
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State | TX
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Zip | 77338-3501
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Country | US
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Telephone | 281-446-2514
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Fax |
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Provider Business Mailing Address
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Address Line | 2111 WILSON BLVD #700 PENN COMPANIES
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City | ARLINGTON
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State | VA
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Zip | 22201-3001
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Country | US
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Telephone | 703-524-0400
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | GRACIE DE LEON
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Credential |
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Telephone | 281-446-2514
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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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