Healthcare Provider Details

I. General information

NPI: 1487778593
Provider Name (Legal Business Name): US RADIOLOGY PARTNERS OF TEXAS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 CLUBHOUSE DR
JONESBORO AR
72401-8078
US

IV. Provider business mailing address

PO BOX 266
SAN ANTONIO TX
78291-0266
US

V. Phone/Fax

Practice location:
  • Phone: 888-326-5522
  • Fax: 972-929-1313
Mailing address:
  • Phone: 409-724-6095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LEAH MCCLAIN
Title or Position: DIRECTOR CREDENTIALING
Credential:
Phone: 208-292-2263