Provider Demographics
NPI:1194936278
Name:INSIGHT MEDICAL DIAGNOSTICS
Entity type:Organization
Organization Name:INSIGHT MEDICAL DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PART OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:BRENAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-498-1543
Mailing Address - Street 1:2225 WILLIAMS TRACE BLVD
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4513
Mailing Address - Country:US
Mailing Address - Phone:281-491-0144
Mailing Address - Fax:
Practice Address - Street 1:2225 WILLIAMS TRACE BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4513
Practice Address - Country:US
Practice Address - Phone:281-491-0144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory