MEDICARE: WILLOWBROOK MRI

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	261QM1200X	Magnetic Resonance Imaging (MRI) Clinic/Center

General Provider Information

NPI Number	:	1093811960
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLOWBROOK MRI

Provider Business Mailing Address
First Line	:	PO BOX 4396
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77210-4396
Country	:	US
Telephone Number	:	281-955-7577
Fax Number	:	281-955-5875

Provider Business Practice Location Address
First Line	:	13300 HARGRAVE RD
Second Line	:	SUITE 110
City	:	HOUSTON
State	:	TX
Zip	:	77070-4373
Country	:	US
Telephone Number	:	281-955-7577
Fax Number	:	281-955-5875

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	DEBBIE MYNATT
Credential	:
Telephone Number	:	281-955-7577

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	08/22/2020

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Directions to “WILLOWBROOK MRI ” Practice Location

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