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Organization
PENN IMAGING OF HUMBLE, LP
Active
Organization
PENN IMAGING OF HUMBLE, LP
Active
Other names
Green Oak Diagnostics
Organization subpart
No
Provider details
NPI number
Authorized official
GRACIE DE LEON (ADMINISTRATOR)
(281) 358-3800
Entity
Organization
Contact information
Practice address
9802 FM 1960 BYPASS RD W STE 100, HUMBLE, TX 77338-3572
(281) 358-3800
(281) 358-3910
Mailing address
9802 FM 1960 BYPASS RD W STE 100, HUMBLE, TX 77338-3572
(281) 358-3800
(281) 358-3910
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
173119201
—
TX
Enumeration date
09/01/2006
Last updated
02/19/2014
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