Basic Information
Provider Information
NPI: 1659628659
EntityType: 2
ReplacementNPI:  
OrganizationName: HEALTH IMAGING PARTNERS LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: ENVISION IMAGING OF LAS COLINAS
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8610 EXPLORER DR
Address2: SUITE 300
City: COLORADO SPRINGS
State: CO
PostalCode: 809201058
CountryCode: US
TelephoneNumber: 7199554332
FaxNumber:  
Practice Location
Address1: 925 W ROYAL LANE
Address2: SUITE 100
City: IRVING
State: TX
PostalCode: 75039
CountryCode: US
TelephoneNumber: 2144836200
FaxNumber: 2144836201
Other Information
ProviderEnumerationDate: 08/08/2012
LastUpdateDate: 01/21/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: BENSON
AuthorizedOfficialFirstName: ANDREW
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CHIEF REVENUE OFFICER
AuthorizedOfficialTelephone: 7199554332
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/21/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
293D00000X  N LaboratoriesPhysiological Laboratory 
2085R0202X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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