Basic Information
| Provider Information | |||||||||
| NPI: | 1700823101 | ||||||||
| 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: | 9729296633 | ||||||||
| FaxNumber: | 4097240214 | ||||||||
| Practice Location | |||||||||
| Address1: | 608 STRICKLAND DR | ||||||||
| Address2: | |||||||||
| City: | ORANGE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 776304717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4098839361 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2006 | ||||||||
| LastUpdateDate: | 05/14/2008 | ||||||||
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| AuthorizedOfficialLastName: | LOWENSTEIN | ||||||||
| AuthorizedOfficialFirstName: | GREG | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9729296633 | ||||||||
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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 |
ID Information
| ID | Type | State | Issuer | Description | 174867501 | 05 | TX | MEDICAID |