MEDICARE: IMAGING WILLOWBROOK, 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	2085R0202X	Diagnostic Radiology Physician
2	261QR0200X	Radiology Clinic/Center

General Provider Information

NPI Number	:	1134324072
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IMAGING WILLOWBROOK, LLC

Provider Business Mailing Address
First Line	:	10370 RICHMOND AVE
Second Line	:	SUITE 1125
City	:	HOUSTON
State	:	TX
Zip	:	77042-4141
Country	:	US
Telephone Number	:	713-785-7828
Fax Number	:	713-785-7858

Provider Business Practice Location Address
First Line	:	22475 TOMBALL PKWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-1530
Country	:	US
Telephone Number	:	713-785-7828
Fax Number	:	713-785-7858

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MARK CESTA
Credential	:	M.D.
Telephone Number	:	713-785-7828

Provider Enumeration Date	:	06/20/2007
Last Update Date	:	09/11/2025

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Directions to “IMAGING WILLOWBROOK, LLC ” Practice Location

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