Organization
CT MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YAZOMAM IBEKWE (MANAGER)
(214) 435-2374
Entity
Organization
Contact information
Practice address
11901 SHADOW CREEK PKWY STE 111B, PEARLAND, TX 77584-7346
(214) 435-2374
Mailing address
1004 CAVERN DR, MESQUITE, TX 75181-4419
(214) 435-2374
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
—
—
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
Primary
—
—
2471M1202X
Magnetic Resonance Imaging Radiologic Technologist
—
—
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
Other
Enumeration date
10/04/2020
Last updated
10/04/2020
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