Provision Imaging of First Street

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

R28949 Issued in TX

Legal business name

PROVISION IMAGING OF FIRST STREET

Practice address

4747 Bellaire Blvd
Suite 101
Bellaire, TX 77401-4527

Phone

(713) 663-7672

Fax

(713) 663-7677

NPI assigned

Jul 26, 2006

Organization subpart

No

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

Authorized official

Name

Robert Matt Trent

Title

Coo

Phone

(405) 842-7768

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619991783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 NW EXPRESSWAY",
            "address_2": "SUITE 1300",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73118",
            "telephone_number": "405-842-7768",
            "fax_number": "405-842-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 BELLAIRE BLVD",
            "address_2": "SUITE 101",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774014527",
            "telephone_number": "713-663-7672",
            "fax_number": "713-663-7677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVISION IMAGING OF FIRST STREET",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TRENT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "MATT",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "405-842-7768"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "TX",
            "license": "R28949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Proactive Minds, PA
• Peter H Proctor, MD
• Professional Anesthesiologists of Texas, P.a.
• Pamela A Promecene-Cook, M.D.
• Providentia DME
• Prysm Wellness
• PT for Kids
• Esther Shiu-Fong Puig, OTR
• Mahesh Pundit, MD
• Pursuit of Happiness Behavioral Health LLC

• Radiology Clinic/Center in Bellaire, TX
• Providers in Bellaire, 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 Aug 22, 2020; 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.