Provider Demographics
NPI:1841032810
Name:PRINCIPLE IMAGING, LLC
Entity type:Organization
Organization Name:PRINCIPLE IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUSINESS OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:BLAKE
Authorized Official - Middle Name:T
Authorized Official - Last Name:WERNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-549-8355
Mailing Address - Street 1:16840 BUCCANEER LN STE 261
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2570
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16840 BUCCANEER LN STE 261
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2570
Practice Address - Country:US
Practice Address - Phone:832-932-5968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRINCIPLE HS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier