MEDICARE: ALLIANCE RADIOLOGY

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	:	1174461099
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIANCE RADIOLOGY

Provider Business Mailing Address
First Line	:	PO BOX 309
Second Line	:
City	:	MEDINA
State	:	TX
Zip	:	78055-0309
Country	:	US
Telephone Number	:	281-773-2018
Fax Number	:

Provider Business Practice Location Address
First Line	:	330 CHAPEL BELLE LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-5038
Country	:	US
Telephone Number	:	281-773-2018
Fax Number	:

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

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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