Provider Demographics
NPI:1053940494
Name:ALLIANCE MRI WOODFOREST
Entity type:Organization
Organization Name:ALLIANCE MRI WOODFOREST
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:JACLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SANFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-955-5705
Mailing Address - Street 1:9811 KATY FWY STE 1075
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1281
Mailing Address - Country:US
Mailing Address - Phone:713-468-3842
Mailing Address - Fax:
Practice Address - Street 1:750 FISH CREEK THOROUGHFARE
Practice Address - Street 2:SUITE 180
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77316
Practice Address - Country:US
Practice Address - Phone:713-468-3842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-07
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiologyGroup - Single Specialty