Conroe Diagnostic Imaging, Inc

Primary specialty

Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X

License

R28478 Issued in TX

Legal business name

CONROE DIAGNOSTIC IMAGING, INC

Practice address

371 Cumberland TRL
Conroe, TX 77302-2903

Phone

(936) 520-8858

NPI assigned

Oct 12, 2012

Organization subpart

No

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

Authorized official

Name

Jim St Vigne

Title

Adminstrator

Phone

(936) 520-8858

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1350000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362614400000",
    "number": "1982956033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "371 CUMBERLAND TRL",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773022903",
            "telephone_number": "936-520-8858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 CUMBERLAND TRL",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773022903",
            "telephone_number": "936-520-8858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONROE DIAGNOSTIC IMAGING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-12",
        "last_updated": "2013-03-07",
        "status": "A",
        "authorized_official_last_name": "ST VIGNE",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "ADMINSTRATOR",
        "authorized_official_telephone_number": "936-520-8858"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "TX",
            "license": "R28478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Magnetic Resonance Imaging (MRI) Clinic/Center in Conroe, TX
• Providers in Conroe, TX by specialty
• Magnetic Resonance Imaging (MRI) Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.