Organization
CONCEPT PHOENIX
Active
Other names
Radiant Imaging & Diagnostics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIP JEFFERSON WEAVER M.D. (CHIEF MEDICAL OFFICER)
(281) 394-1300
Entity
Organization
Contact information
Practice address
1336 PIN OAK RD, KATY, TX 77494-6849
(281) 394-1300
(281) 394-1301
Mailing address
1336 PIN OAK RD, KATY, TX 77494-6849
(281) 394-1300
(281) 394-1301
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LO5864
RAM LICENSE
TX
Enumeration date
08/29/2006
Last updated
08/22/2020
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