MEDICARE: PROVISION IMAGING OF EAST HOUSTON

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	:	1689766545
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROVISION IMAGING OF EAST HOUSTON

Provider Business Mailing Address
First Line	:	1601 NW EXPRESSWAY
Second Line	:	SUITE 1300
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118
Country	:	US
Telephone Number	:	405-842-7768
Fax Number	:	405-842-7789

Provider Business Practice Location Address
First Line	:	11110 EAST FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77029-1914
Country	:	US
Telephone Number	:	713-637-6905
Fax Number	:	713-637-6940

Authorized Official
Title or Position	:	COO
Name	:	MR. ROBERT MATT TRENT
Credential	:
Telephone Number	:	405-842-7768

Provider Enumeration Date	:	09/29/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1932103744 — DR. ALVARO RENE GARCIA M.D.
Practice Location Address:

11110 EAST FWY
HOUSTON, TX
77029-1914

Practice Phone: 713-461-2915
Practice Fax: 713-461-5307

1013960228 — DR. RONALD WAYNE KILLAM MD
Practice Location Address:

11110 EAST FWY STE 100A
HOUSTON, TX
77029-1914

Practice Phone: 713-330-0766
Practice Fax: 877-862-8370

1467557231 — ALVARO R GARCIA, MD, PA
Practice Location Address:

11110 EAST FWY
HOUSTON, TX
77029-1914

Practice Phone: 713-450-3505
Practice Fax: 713-451-4321

1689810517 — STAR REX PHARMACY LLC
Practice Location Address:

11110 EAST FWY , 100B
HOUSTON, TX
77029-1914

Practice Phone: 832-767-0816
Practice Fax: 832-767-0819

1407111941 — ONE STEP DIAGNOSTIC X LP
Practice Location Address:

11110 EAST FWY , SUITE 100A
HOUSTON, TX
77029-1914

Practice Phone: 713-461-7272
Practice Fax:

1396332235 — MISS GLENDA HALL AGPCNP-BC
Practice Location Address:

11110 EAST FWY STE 200
HOUSTON, TX
77029-1914

Practice Phone: 713-450-3505
Practice Fax: 713-451-4321

Directions to “PROVISION IMAGING OF EAST HOUSTON ” Practice Location

Language	Start Address	Practice Location

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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.