MEDICARE: PIONEER IMAGING, LLC

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	261QR0200X	Radiology Clinic/Center

General Provider Information

NPI Number	:	1114323375
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIONEER IMAGING, LLC

Provider Business Mailing Address
First Line	:	10700 STANCLIFF RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77099-4307
Country	:	US
Telephone Number	:	832-300-4601
Fax Number	:	832-300-4145

Provider Business Practice Location Address
First Line	:	10700 STANCLIFF RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77099-4307
Country	:	US
Telephone Number	:	832-300-4601
Fax Number	:	832-300-4145

Authorized Official
Title or Position	:	CEO
Name	:	MR. FAHAD NAVEED
Credential	:
Telephone Number	:	832-300-4601

Provider Enumeration Date	:	11/14/2014
Last Update Date	:	11/14/2014

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Directions to “PIONEER IMAGING, LLC ” Practice Location

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