Basic Information
| Provider Information | |||||||||
| NPI: | 1134232549 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SPENCER RADIOLOGY NO 3 LLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3000 RICHMOND AVE | ||||||||
| Address2: | #300 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770983102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7135126000 | ||||||||
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| Address1: | 3000 RICHMOND AVE | ||||||||
| Address2: | #300 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770983102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7135126000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2006 | ||||||||
| LastUpdateDate: | 10/04/2007 | ||||||||
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| AuthorizedOfficialLastName: | AKESON | ||||||||
| AuthorizedOfficialFirstName: | STUART | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 2813587758 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.