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NPI Code Detail

MEDICARE: PERMIAN IMAGING LLC

MEDICARE: PERMIAN IMAGING LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0200XRadiology Clinic/Center

General Provider Information

NPI Number : 1316822612
Entity Type Code : Organization
Provider Name (Legal Business Name) : PERMIAN IMAGING LLC
Provider Business Mailing Address
First Line : 500 E 4TH ST
Second Line :
City : ODESSA
State : TX
Zip : 79761-5110
Country : US
Telephone Number : 432-614-4001
Fax Number :
Provider Business Practice Location Address
First Line : 500 E 4TH ST
Second Line :
City : ODESSA
State : TX
Zip : 79761-5110
Country : US
Telephone Number : 432-614-4001
Fax Number : 432-363-0952
Authorized Official
Title or Position : CFO
Name : BETTY QUIROZ
Credential :
Telephone Number : 432-413-1697
Provider Enumeration Date : 08/07/2025
Last Update Date : 08/07/2025

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Directions to “PERMIAN IMAGING LLC ” Practice Location

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