MEDICARE: ALLIANCE MOBILE IMAGING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0208X	Mobile Radiology Clinic/Center

General Provider Information

NPI Number	:	1073975777
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIANCE MOBILE IMAGING

Provider Business Mailing Address
First Line	:	9811 KATY FWY
Second Line	:	SUITE 1075
City	:	HOUSTON
State	:	TX
Zip	:	77024-1273
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9811 KATY FWY
Second Line	:	SUITE 1075
City	:	HOUSTON
State	:	TX
Zip	:	77024-1273
Country	:	US
Telephone Number	:	713-468-3842
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	ETHAN SANDERS
Credential	:
Telephone Number	:	281-773-2018

Provider Enumeration Date	:	03/22/2016
Last Update Date	:	03/22/2016

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Directions to “ALLIANCE MOBILE IMAGING ” Practice Location

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