Organization Name: | MAGNOLIA IMAGING PLLC |
NPI Number: | 1518236314 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KHADIJA AZIZ (RADIOLOGIST) |
Mailing Address: | 2701 Bay Shore Dr Seabrook |
State: | TX US |
Postal Code: | 775861692 |
Phone Number: | 2813360224 |
Fax Number: | 2813360224 |
NPI Enumeration Date: | 12/22/2011 |
NPI Last Update Date: | 03/12/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0206X |
License Number: | N4268 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Radiology, Mammography |
Taxonomy Definition: |