Basic Information
| Provider Information | |||||||||
| NPI: | 1679697684 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | US RADIOLOGY PARTNERS OF TEXAS INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 266 | ||||||||
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| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782910266 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4097246095 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1434 S LARKSPUR CT | ||||||||
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| City: | LAFAYETTE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800268003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8883265522 | ||||||||
| FaxNumber: | 9729291313 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2007 | ||||||||
| LastUpdateDate: | 11/13/2007 | ||||||||
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| AuthorizedOfficialLastName: | MCCLAIN | ||||||||
| AuthorizedOfficialFirstName: | LEAH | ||||||||
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| AuthorizedOfficialTitleorPosition: | ENROLLMENT SPECIALIST | ||||||||
| AuthorizedOfficialTelephone: | 2082922263 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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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.