Fairmont Diagnostic and MRI Center LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

R24938 Issued in TX

Legal business name

FAIRMONT DIAGNOSTIC AND MRI CENTER LLC

Practice address

3692 E Sam Houston Pkwy S
Pasadena, TX 77505-3137

Phone

(832) 455-4852

Fax

(281) 487-1766

NPI assigned

Jun 20, 2011

Last updated

Jul 13, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Michael Ray McCombs

Title

Owner

Phone

(281) 487-6736

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310515200000",
    "number": "1235425059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3692 E SAM HOUSTON PKWY S",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775053137",
            "telephone_number": "281-487-6736",
            "fax_number": "281-487-1766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3692 E SAM HOUSTON PKWY S",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775053137",
            "telephone_number": "832-455-4852",
            "fax_number": "281-487-1766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRMONT DIAGNOSTIC AND MRI CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-20",
        "last_updated": "2011-07-13",
        "status": "A",
        "authorized_official_last_name": "MCCOMBS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-487-6736",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "TX",
            "license": "R24938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ayo Renee Ezeamama, MSN
• Nnachebe Festus Ezechigbo
• Kristen Ezeude, MD
• Robert Leo Fairchild, MD
• Fairmont Childrens PLLC
• Fairmont Diagnostic Center and Open MRI
• Fairmont Endoscopy Center
• Fairmont Infusion Center, PLLC
• Fairmont Medical Clinic , PA
• Fairmont Pediatrics and Associates

• Radiology Clinic/Center in Pasadena, TX
• Providers in Pasadena, TX by specialty
• Radiology Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.