MEDICARE: UNIVERSAL NORMANDY MRI

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		TX

General Provider Information

NPI Number	:	1366482903
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSAL NORMANDY MRI

Provider Business Mailing Address
First Line	:	PO BOX 22789
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77227-2789
Country	:	US
Telephone Number	:	713-622-4480
Fax Number	:	713-622-4465

Provider Business Practice Location Address
First Line	:	12747 I-10 FREEWAY EAST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77015-5605
Country	:	US
Telephone Number	:	713-453-3144
Fax Number	:	713-453-4939

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. GUS PARVIZIAN
Credential	:	MR
Telephone Number	:	713-960-8104

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	01/08/2008

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