Provider Demographics
NPI:1053804609
Name:ICGH - IMAGING CENTERS OF GREATER HOUSTON LLC
Entity type:Organization
Organization Name:ICGH - IMAGING CENTERS OF GREATER HOUSTON LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAHEEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-345-4244
Mailing Address - Street 1:6300 RICHMOND AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-5931
Mailing Address - Country:US
Mailing Address - Phone:877-345-4244
Mailing Address - Fax:
Practice Address - Street 1:200 RIVER POINTE DR STE 130
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2828
Practice Address - Country:US
Practice Address - Phone:936-756-2299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-08
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology