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NPI Code Detail

MEDICARE: CONCEPT PHOENIX

MEDICARE: CONCEPT PHOENIX
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
1261QR0200XRadiology Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1LO5864OTHERTXRAM LICENSE

General Provider Information

NPI Number : 1255440046
Entity Type Code : Organization
Provider Name (Legal Business Name) : CONCEPT PHOENIX
Provider Business Mailing Address
First Line : 1336 PIN OAK RD
Second Line :
City : KATY
State : TX
Zip : 77494-6849
Country : US
Telephone Number : 281-394-1300
Fax Number : 281-394-1301
Provider Business Practice Location Address
First Line : 1336 PIN OAK RD
Second Line :
City : KATY
State : TX
Zip : 77494-6849
Country : US
Telephone Number : 281-394-1300
Fax Number : 281-394-1301
Authorized Official
Title or Position : CHIEF MEDICAL OFFICER
Name : DR. PHILIP JEFFERSON WEAVER
Credential : M.D.
Telephone Number : 281-394-1300
Provider Enumeration Date : 08/29/2006
Last Update Date : 08/22/2020

Similar Medicare Providers

1285965566 — TEXAS INHOME HEALTHCARE, LLC
Practice Location Address:
1334 PIN OAK RD
KATY, TX
77494-6849
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1669704458 — UNIHEALTH MEDICAL CLINIC, LLC
Practice Location Address:
1334 PIN OAK RD
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Practice Fax:
1780083485 — DRH & ASSOCIATES, INC.
Practice Location Address:
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Practice Phone: 713-425-8118
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1518348002 — PIN OAK MEDICAL CENTER LLC
Practice Location Address:
1334 PIN OAK RD
KATY, TX
77494-6849
Practice Phone: 331-305-2813
Practice Fax:
1669837209 — MACTIVA ANESTHESIA ASSOCIATES PLLC
Practice Location Address:
1334 PIN OAK RD
KATY, TX
77494-6849
Practice Phone: 281-727-0076
Practice Fax: 281-727-0420
1942850870 — YULIA ZOLOTAYKO-MERCHANT FNP
Practice Location Address:
1334 PIN OAK RD
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Practice Fax:

Directions to “CONCEPT PHOENIX ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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