Healthcare Provider Details

I. General information

NPI: 1982919593
Provider Name (Legal Business Name): AUSTIN RADIOLOGICAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2010
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

970 NORTH KALAHEO AVENUE SUITE A-307
KAILUA HI
96734-1870
US

IV. Provider business mailing address

12554 RIATA VISTA CIR
AUSTIN TX
78727-6431
US

V. Phone/Fax

Practice location:
  • Phone: 808-254-3014
  • Fax:
Mailing address:
  • Phone: 512-795-5100
  • Fax: 512-519-3451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License NumberR00151
License Number StateTX

VIII. Authorized Official

Name: SHARLEE LEBLEU
Title or Position: VICE PRESIDENT
Credential:
Phone: 480-321-7026