Organization
OPEN MRI OF WHARTON, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL S. RICHARD EXECUTIVE DIRECTOR (EXECUTIVE DIRECTOR)
(979) 532-1749
Entity
Organization
Contact information
Practice address
1307 HOSPITAL DRIVE, WHARTON, TX 77488
(979) 532-1749
Mailing address
1307 HOSPITAL DRIVE, WHARTON, TX 77488
(979) 532-1749
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0187DC
BCBS OF TEXAS
TX
05
—
143867302
—
TX
01
—
470001050
RAILROAD GBA - RAILROAD MEDICARE
TX
Enumeration date
01/19/2007
Last updated
06/14/2011
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