Active NPI
Imd Healthcare and Imaging
- Health Service Clinic/Center
- Houston, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Service Clinic/Center
- License
- K1456
- Legal business name
- IMD HEALTHCARE AND IMAGING
- Practice address
- 13107 W Lake Houston Pkwy
Houston, TX 77044-5391 - Phone
- (281) 360-3269
- NPI assigned
- Dec 22, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Humara S Gull, M.D.
- Title
- Ceo and President
- Phone
- (281) 360-3269
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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Service Clinic/Center | 261QH0100X | K1456 | TX | Primary |
| Medical Specialty Clinic/Center | 261QM2500X | K1456 | TX | |
| Radiology Clinic/Center | 261QR0200X | K1456 | TX |
Addresses
Primary practice location
13107 W Lake Houston Pkwy
Houston, TX 77044-5391
Mailing address
7403 Kings River CT
Kingwood, TX 77346-1475
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120309000493 | TX | Part B Supplier - Clinic/Group Practice | 2365601309 |
Receives reassigned benefits from 9 practitioners Practice locations: Humble, TX; Kingwood, TX |
National Provider Directory
National Provider DirectoryLocations
13107 W Lake Houston Pkwy
Houston, TX 77044
Phone (281) 360-3269
19411 McKay Dr
Ste 150
Humble, TX 77338
Phone (281) 459-9181
11331 N Sam Houston Pkwy E
Humble, TX 77396
Phone (281) 459-9181
8450 Will Clayton Pkwy
Humble, TX 77338
Phone (281) 446-8484
Practitioners & affiliated clinicians
Practitioners 9
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Saint Paul, MN
- NPI 1770040487
Multi-Specialty, TX
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": "1324512000000",
"number": "1992074710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7403 KINGS RIVER CT",
"city": "KINGWOOD",
"state": "TX",
"postal_code": "773461475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13107 W LAKE HOUSTON PKWY",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770445391",
"telephone_number": "281-360-3269"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "IMD HEALTHCARE AND IMAGING",
"organizational_subpart": "NO",
"enumeration_date": "2011-12-22",
"last_updated": "2011-12-22",
"status": "A",
"authorized_official_last_name": "GULL",
"authorized_official_first_name": "HUMARA",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "CEO AND PRESIDENT",
"authorized_official_telephone_number": "281-360-3269",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "261QH0100X",
"taxonomy_group": "",
"desc": "Clinic/Center, Health Service",
"state": "TX",
"license": "K1456",
"primary": true
},
{
"code": "261QM2500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Medical Specialty",
"state": "TX",
"license": "K1456",
"primary": false
},
{
"code": "261QR0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Radiology",
"state": "TX",
"license": "K1456",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.