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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