Memorial MRI & Diagnostic, LLC

Primary specialty

Nuclear Radiology PhysicianTaxonomy code 2085N0904X

License

L05997 Issued in TX

Legal business name

MEMORIAL MRI & DIAGNOSTIC, LLC

Doing business as

Memorial Nuclear Imaging

Practice address

8800 Katy Fwy Ste 105
Houston, TX 77024-1645

Phone

(713) 461-3399

Fax

(713) 461-1969

NPI assigned

Sep 28, 2006

Last updated

Jul 26, 2019By 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

Jorrie Fatheree

Title

Manager

Phone

(713) 461-3399

Specialties & licenses 6

Addresses

Other identifiers 2

Other names 1

• Memorial Nuclear Imaging Doing business as

Tax ID family

Memorial MRI Diagnostic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Memorial MRI and Diagnostic LLC

  • Diagnostic Radiology Physician
  • Houston, TX
  • NPI 1912989120
  NPD tax ID

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564099200000",
    "number": "1447341797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 802185",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772802185",
            "telephone_number": "713-461-3399",
            "fax_number": "713-461-1969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8800 KATY FWY STE 105",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770241645",
            "telephone_number": "713-461-3399",
            "fax_number": "713-461-1969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL MRI & DIAGNOSTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2019-07-26",
        "status": "A",
        "authorized_official_last_name": "FATHEREE",
        "authorized_official_first_name": "JORRIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "713-461-3399"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "TX",
            "license": "L05997",
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "TX",
            "license": "L05997",
            "primary": false
        },
        {
            "code": "207UN0902X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Imaging & Therapy",
            "state": "TX",
            "license": "L05997",
            "primary": false
        },
        {
            "code": "207UN0903X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, In Vivo & In Vitro Nuclear Medicine",
            "state": "TX",
            "license": "L05997",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "TX",
            "license": "L05997",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "L05997",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS, BLUE SHIELD",
            "identifier": "0203DC",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153985002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Nuclear Imaging",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Memorial Nuclear Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Memorial Medical Staffing Services
• Memorial Medical Supply
• Memorial Medical Supply, Inc.
• Memorial Men's Health, LP
• Memorial Modern Dentistry,PC (Memorial Modern Dentistry)
• Memorial MRI and Diagnostic LLC
• Memorial Neurological Association
• Memorial Northwest Emergency Physicians, LLP
• Memorial Northwest Hearing AIDS, LLC (Mem NW Hearing Aids, LLC)
• Memorial NW Otolaryngology Head & Neck Surgery Associates (Memorial Village ENT)

• Nuclear Radiology Physician in Houston, TX
• Providers in Houston, TX by specialty
• Nuclear Radiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; 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.