Basic Information
| Provider Information | |||||||||
| NPI: | 1003979303 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RADIOLOGY SPECIALISTS, LTD. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4101 WAGON TRAIL AVE | ||||||||
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| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891184426 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7029424123 | ||||||||
| FaxNumber: | 7029424124 | ||||||||
| Practice Location | |||||||||
| Address1: | 9300 W SUNSET RD | ||||||||
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| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891484844 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7028802948 | ||||||||
| FaxNumber: | 7028802954 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/18/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | LUSIANI | ||||||||
| AuthorizedOfficialFirstName: | CHRIS | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 7029424122 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | J.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.