MEDICARE: HEARTSCAN OF N.W. HOUSTON, LP

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	261QM2500X	Medical Specialty Clinic/Center	N/A

General Provider Information

NPI Number	:	1851347413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARTSCAN OF N.W. HOUSTON, LP

Provider Business Mailing Address
First Line	:	10902 FM 1960 RD W
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-6316
Country	:	US
Telephone Number	:	832-237-1117
Fax Number	:	832-237-1119

Provider Business Practice Location Address
First Line	:	10902 FM 1960 RD W
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-6316
Country	:	US
Telephone Number	:	832-237-1117
Fax Number	:	832-237-1119

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. GREGG GARRARD
Credential	:
Telephone Number	:	832-237-1117

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	08/22/2020

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