Organization
IMAGING CENTERS OF TEXAS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINNY MOUNT JACOBS (PRESIDENT)
(281) 793-6998
Entity
Organization
Contact information
Practice address
3101 HIGHWAY 71 E STE 108, BASTROP, TX 78602-5159
(281) 793-6998
Mailing address
1018 TRAILWOOD ESTATES DR, MAGNOLIA, TX 77354-3530
(281) 793-6998
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
07/25/2018
Last updated
10/23/2019
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