Basic Information
Provider Information
NPI: 1114443983
EntityType: 2
ReplacementNPI:  
OrganizationName: TEXAS MRI PARTNERS LLC
LastName:  
FirstName:  
MiddleName:  
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Credential:  
OtherOrganizationName: TEXAS MRI OF HOUSTON
OtherOrganizationType: 3
OtherLastName:  
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Mailing Information
Address1: 3720 20TH ST
Address2:  
City: LUBBOCK
State: TX
PostalCode: 794101208
CountryCode: US
TelephoneNumber: 8067926736
FaxNumber:  
Practice Location
Address1: 17482 NORTHWEST FWY
Address2:  
City: JERSEY VILLAGE
State: TX
PostalCode: 770401024
CountryCode: US
TelephoneNumber: 7138565955
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/14/2017
LastUpdateDate: 08/14/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: NEIDERT
AuthorizedOfficialFirstName: ROBERT
AuthorizedOfficialMiddleName: S
AuthorizedOfficialTitleorPosition: ADMINISTRATOR
AuthorizedOfficialTelephone: 7139227247
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QM1200X  Y Ambulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)

No ID Information.


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