Imaging Center of Magnolia PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

IMAGING CENTER OF MAGNOLIA PLLC

Practice address

827 Magnolia Blvd Ste 2
Suite B
Magnolia, TX 77355-8553

Phone

(281) 789-4329

Fax

(281) 789-4339

NPI assigned

May 29, 2013

Organization subpart

No

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

Authorized official

Name

Donna K Kotsios

Title

Practice Administrator

Phone

(281) 296-9562

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1369785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369785600000",
    "number": "1780021956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4185 TECHNOLOGY FOREST BLVD",
            "address_2": "SUITE 120",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773812006",
            "telephone_number": "281-296-9562",
            "fax_number": "281-296-9774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 MAGNOLIA BLVD STE 2",
            "address_2": "SUITE B",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773558553",
            "telephone_number": "281-789-4329",
            "fax_number": "281-789-4339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGING CENTER OF MAGNOLIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-29",
        "last_updated": "2013-05-29",
        "status": "A",
        "authorized_official_last_name": "KOTSIOS",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "281-296-9562"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; 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.