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NPI Code Detail

MEDICARE: REGEN MEDICAL IMAGING INC

MEDICARE: REGEN MEDICAL IMAGING INC
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
12085R0202XDiagnostic Radiology Physician

General Provider Information

NPI Number : 1861760126
Entity Type Code : Organization
Provider Name (Legal Business Name) : REGEN MEDICAL IMAGING INC
Provider Business Mailing Address
First Line : 15650 CLASSEN RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78247-2184
Country : US
Telephone Number : 210-236-8076
Fax Number : 210-236-8078
Provider Business Practice Location Address
First Line : 15650 CLASSEN RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78247-2184
Country : US
Telephone Number : 210-236-8076
Fax Number : 210-236-8078
Authorized Official
Title or Position : PRESIDENT
Name : ANNA BALLARD
Credential :
Telephone Number : 210-236-8076
Provider Enumeration Date : 12/01/2011
Last Update Date : 12/01/2011

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Directions to “REGEN MEDICAL IMAGING INC ” Practice Location

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