MEDICARE: MEDICAL IMAGING ASSOCIATES OF AMERICA, PA

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	2085R0202X	Diagnostic Radiology Physician
2	261QR0206X	Mammography Clinic/Center

General Provider Information

NPI Number	:	1790226710
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL IMAGING ASSOCIATES OF AMERICA, PA

Provider Business Mailing Address
First Line	:	5037B FM 2920 RD
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77388-3114
Country	:	US
Telephone Number	:	281-453-7916
Fax Number	:

Provider Business Practice Location Address
First Line	:	1351 CLEAR LAKE CITY BLVD STE 300
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77062-2372
Country	:	US
Telephone Number	:	346-326-2490
Fax Number	:	844-656-3680

Authorized Official
Title or Position	:	MD
Name	:	MINH NGUYEN
Credential	:	MD
Telephone Number	:	281-453-7232

Provider Enumeration Date	:	03/09/2017
Last Update Date	:	11/03/2021

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