NPIMap

Organization Active NPI

Magnolia Imaging PLLC

  • Mammography Clinic/Center
  • Seabrook, TX
National Provider Identifier
1518236314
Registry record updated Mar 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mammography Clinic/CenterTaxonomy code 261QR0206X
License
N4268 Issued in TX
Legal business name
MAGNOLIA IMAGING PLLC
Practice address
2701 Bay Shore Dr
Seabrook, TX 77586-1692
Phone
(281) 336-0224
Fax
(281) 336-0224
NPI assigned
Dec 22, 2011
Last updated
Mar 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2012

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

Authorized official

Name
Khadija Aziz, MDNPI 1336186097
Title
Radiologist
Phone
(281) 336-0224

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mammography Clinic/Center 261QR0206X N4268 TX Primary

Addresses

Primary practice location

2701 Bay Shore Dr
Seabrook, TX 77586-1692

Mailing address

2701 Bay Shore Dr
Seabrook, TX 77586-1692
Phone (281) 336-0224

Other identifiers 1

IdentifierTypeStateIssuer
64072721MedicaidKY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1324512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331510400000",
    "number": "1518236314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 BAY SHORE DR",
            "city": "SEABROOK",
            "state": "TX",
            "postal_code": "775861692",
            "telephone_number": "281-336-0224",
            "fax_number": "281-336-0224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 BAY SHORE DR",
            "city": "SEABROOK",
            "state": "TX",
            "postal_code": "775861692",
            "telephone_number": "281-336-0224",
            "fax_number": "281-336-0224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA IMAGING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-22",
        "last_updated": "2012-03-12",
        "status": "A",
        "authorized_official_last_name": "AZIZ",
        "authorized_official_first_name": "KHADIJA",
        "authorized_official_title_or_position": "RADIOLOGIST",
        "authorized_official_telephone_number": "281-336-0224",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": "TX",
            "license": "N4268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64072721",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seabrook, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2012; 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.