MEDICARE: TEXAN IMAGING CENTERS, LP

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	247100000X	Radiologic Technologist

General Provider Information

NPI Number	:	1164661385
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAN IMAGING CENTERS, LP

Provider Business Mailing Address
First Line	:	PO BOX 741126
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77274-1126
Country	:	US
Telephone Number	:	713-532-7311
Fax Number	:	713-532-7399

Provider Business Practice Location Address
First Line	:	2101 CRAWFORD ST STE 115
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77002-8900
Country	:	US
Telephone Number	:	713-655-7226
Fax Number	:	713-655-8888

Authorized Official
Title or Position	:	COO
Name	:	OMAR KIGGUNDU
Credential	:
Telephone Number	:	713-532-7311

Provider Enumeration Date	:	02/11/2009
Last Update Date	:	06/17/2009

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