MEDICARE: MRI CENTERS OF TEXAS, LLC- NORTH HOUSTON SERIES

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	:	1992443345
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MRI CENTERS OF TEXAS, LLC- NORTH HOUSTON SERIES

Provider Business Mailing Address
First Line	:	2151 FORT WORTH AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75211-1812
Country	:	US
Telephone Number	:	972-498-1963
Fax Number	:

Provider Business Practice Location Address
First Line	:	156 FM 1960 RD STE N
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77073-1820
Country	:	US
Telephone Number	:	972-498-1963
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT AND CHIEF EXECUTIVE OFFIC
Name	:	ROBERT BROOKSON SHIELDS
Credential	:
Telephone Number	:	972-498-1963

Provider Enumeration Date	:	05/25/2022
Last Update Date	:	11/12/2024

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